摘要：目的比較Bilibed(R)與傳統六管頂射光照對新生兒黃膽的療效,血清膽紅素的下降率,嬰兒體重和體溫的改變,護理凖備時間及家人的滿意程度.方法選取20名經隨機符合標凖有新生兒黃膽的足月嬰兒來分別接受Bilibed(R)或傅統頂射光照治療.比較兩種光照治療的效果是透過定期的血液膽紅素測試,體重體溫量度及護理凖備時間來評估,兩種光照治療都是以零開始計算時間.家人的滿意程度是透過問卷調查了解其有關的方便程度和個人喜好.結果 20名由37週至41過的嬰兒經過隨機抽樣選取,其中有9名嬰兒接受Bilibed(R)光照治療,有11名嬰兒接受傳統頂射光照治療.Bilibed(R)組與傳統光照組嬰兒的血清膽紅素水平在開始接受治療前是大致相約,Bilibed(R)組的血紅素水平為265.44±18.16 μgmol/1,而傳統光照組的血紅素水平為253.04±14.42 μgmol/1.平均膽血紅素每小時下降率之比較,於Bilibed(R)組為1.7±0.98 μgmol/1/小時,而傳統光照組為2.30±0.97 μgmol/1/小時,兩組的血清膽紅素下降率在統計學上並無分別( P=0.074).平均總照射時間之比較,於Bilibed(R)組為40.20±14.78小時,而傅統頂射光照組則為35.52±16.4小時,在統計學上並無分別.至於比較護理準備至開始照射的時間,於Bilibed(R)組為6.67±3.54分鐘,而傳統頂射光照組則為20.4±8.13分鐘,前者所需時間遠較後者所需少,在統計學上有嚴重的分別(P=0.004).結編在我們的研究中,Bilibed(R)組相對傳統頂射光照組在降低血清膽紅素水平方面有相同的效果,而所需的護理凖備時間少,加上Bilibed(R)治療法減少影響母子親和,同樣它亦是家長滿意接受的治療方法.%Objective To compare Bilibed(R) phototherapy (Bilibed(R), Medelda AG, Switzerland) with conventional phototherapy using 6 overhead daylight fluorescence lamps (Philips TLD 18W, Philips Lighting Co.)with respect to the rate of fall in bilirubin, change in body weight and temperature, the time for nursing preparation and the preference of parents. Method 20 Term baby with neonatal jaundice who fulfilled the inclusion criteria were randomized to receive either Bilibed(R) or conventional phototherapy. The effects of both forms ofphototherapy was assessed by regular monitoring of serum bilirubin level, body weight, body temperature and nursing preparation time for setting up both therapies at 0 hour. Parent's preference was assessed by questionnaire addressing convenience and personal choice. Results 20 neonates with age ranges from 37 to 42 gestational weeks were recruited. Nine were treated with Bilibed(R)and 11 with conventional therapy. The initial bilirubin level at 0 hour was similar between the Bilibed(R)(265.44 ± 18.16 μtgmol/1) and conventional phototherapy (253.64 ± 14.42 μgmol/1). The mean rate of fall of bilirubin in the Bilibed(R) arm was 1.71 ± 0.98 μgmol/1/hr and that of the conventional arm is 2.30 ± 0.79 μgmol/l/hr. There was no statistical difference on the rate of fall ofbilirubin between the two groups (p=0.074). The mean total therapy time of Bilibed(R) arm was 40.20 ± 14.78 hours while that of conventional arm was 35.52 ± 16.42 hours. There was no difference statistically (p=0.21). The nursing time for setting up Bilibed(R) at the beginning of phototherapy 6.67 ± 3.54 minutes is significantly shorter than that of conventional phototherapy 20.45± 8.13 minutes is (p=0.0004). Conclusion In our study, Bilibed(R) was as effective as conventional phototherapy in reducing the serum bilirubin level and required less nursing time in the initial setup and less disruption of parental bonding. It was also the preferred treatment by parents.
