影响新生儿脑组织氧饱和度相关因素的研究

目的:应用近红外光谱测定技术(near-infrared spectroscopy,NIRS)检测正常及疾病状态下新生儿脑组织氧饱和度(regional oxygen saturation,rSO2),探讨影响新生儿rSO2的相关因素,验证正常足月新生儿出生后的脑rSO2正常值的可靠性。方法:应用NIRS技术,研究500例正常足月新生儿出生后的脑rSO2变化同时,测定110例患有影响脑rSO2疾病的新生儿,对照两组间脑rSO2差异。结果:正常新生儿脑rSO2测定值为(62.03±2.51)%,疾病状态下新生儿rSO2测定值为(53.18±5.59)%,差异有统计学意义(P<0.05)。正常足月新生儿阴道分娩组与剖宫产组脑rSO2差异无统计学意义(P>0.05),产前有合并胎儿窘迫或羊水Ⅲ度污染生后无症状的新生儿出生后脑rSO2在出生后第1天、第2天均略高于正常新生儿,差异有统计学意义(P<0.05),在出生第3天以后脑rSO2数值接近,两组之间差异无统计学意义(P>0.05)。结论:分娩方式对正常足月新生儿脑rSO2测定值影响无显著意义;产前有合并胎儿窘迫或羊水Ⅲ度污染生后无症状的新生儿出生后脑rSO2仅在出生后第1天、第2天均略高于正常新生儿,差异有统计学意义;疾病状态下的脑rSO2明显低于正常足月儿。NIRS检测技术能够客观反应脑rSO2的氧合状态。正常足月新生儿测得的正常值范围值可信,<57.9%提示脑组织缺氧。

Study on related effect factors of cerebral regional oxygen saturation of neonates

Objective:To detect the neonatal cerebral regional oxygen saturation(rSO2) of healthy neonates and sick neonates by near infrared spectroscopy,explore related effect factors of rSO2,verify the reliability of reference value of rSO2 of healthy neonates.Methods:The rSO2 of 500 healthy neonates and 110 sick neonates whose diseases may affect rSO2 were detected,and the results were compared between the two groups.Results:rSO2 of healthy neonates and sick neonates were(62.03±2.51)% and(53.18±5.59)%,respectively,there was significant difference(P<0.05).There was no significant difference in rSO2 of normal full-term neonates between vaginal delivery group and cesarean section group(P>0.05);on the first and second day after birth,rSO2 of the asymptomatic neonates with fetal distress or amniotic fluid contamination Ⅲ were significant higher than that of normal neonates(P<0.05),but there was no difference on the third day after birth(P>0.05).Conclusion:Delivery modes affect rSO2 of normal full-term neonates slightly;on the first and second day after birth,rSO2 of the asymptomatic neonates with fetal distress or amniotic fluid contamination Ⅲ are significant higher than that of normal neonates;rSO2 of sick neonates is lower than that of healthy neonates;near infrared spectroscopy can reflect the oxygenation state;reference value of rSO2 of healthy neonates is reliable,less than 57.9% indicates cerebral hypoxia.