Direkt coombs pozitif yenidoğanlarda light emitting diode fototerapinin etkinliği

Yıl 2019, Cilt: 16 Sayı: 2, 169 - 173, 29.08.2019

Nilüfer Okur , Mehmet Büyüktiryaki , Nurdan Uras , Mehmet Yekta Öncel , Ömer Ertekin , Fuat Emre Canpolat , Şerife Suna Oğuz

https://doi.org/10.35440/hutfd.525717

Öz

Amaç: Fototerapi, serum
bilirubin düzeyleri fizyolojik sınırları aştığında en sık kullanılan tedavi
yöntemidir. Direkt antiglobulin titresi (DAT) testi yenidoğanın immün hemolitik
hastalığı tanısının temel taşı olarak kabul edilir.

Materyal ve Metot: Hastanemizde doğan ve
gebelik yaşı 35 haftadan fazla olan hiperbilirubinemili hastalar çalışmaya
alındı. DAT pozitif ve DAT negatif hastalar light emitting diode (LED)
fototerapi etkinliği açısından karşılaştırıldı.

Bulgular: Yetmiş yedi olgu DAT
negatif, 72 olgu DAT pozitif idi. DAT pozitif ve negatif gruplar arasında
fototerapi ve hastanede yatış süresi açısından istatistiksel olarak anlamlı bir
fark bulunmadı. DAT pozitif grupta hastaların fototerapi gereksinimlerinin daha
erken bir aşamada (doğum sonrası yaş 1.4 gün, p <0.05) olduğu tespit edildi,
exchange transfüzyon ve intravenöz immunoglobulin (IVIG) gerektiren hastaların
oranı DAT pozitif bebeklerde istatistiksel olarak anlamlı derecede yüksekti.

Sonuç: LED fototerapi DAT
pozitif hastalarda etkilidir ancak kan değişimi ihtiyacı ve IVIG bu hastalarda
hala daha etkili fototerapiye ihtiyaç olduğunu göstermektedir.

Anahtar Kelimeler

Direkt antiglobulin, Hiperbilirubinemi, Yenidoğan, Fototerapi

Effectiveness of light emitting diode phototherapy for direct coombs positive newborns

Öz

Background: Phototherapy
is the most frequently used treatment when serum bilirubin levels exceed
physiological limits. The direct antiglobulin titer (DAT) test is regarded as
the cornerstone of diagnosis of immune hemolytic disease of the newborn.

Methods: Patients with
hyperbilirubinemia who were born in our hospital and whose gestational age was
over 35 weeks were enrolled. DAT positive and DAT negative patients were
compared in terms of light emitting diode (LED) phototherapy efficacy.

Results: Seventy-seven
cases were DAT-negative and 72 were DAT-positive. No statistically significant
differences were found for the duration of phototherapy and hospitalization
between the DAT-positive and negative groups. In the DAT-positive group, the
phototherapy needs of the patients were determined to occur at an earlier stage
(postnatal age 1.4 day, p<0.05), and the rate of patients requiring exchange
transfusion, blood transfusion and intravenous immunoglobulin was found to be
statistically significant higher in DAT-positive infants.

Conclusions: Although LED
phototherapy is effective in DAT-positive patients, the need for  exchange transfusion and intravenöz
immunoglobulin  (IVIG) shows that there
is still a need for more effective phototherapy in these patients.

Anahtar Kelimeler

Direct antiglobulin, hyperbilirubinemia, newborn, phototherapy

Kaynakça

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