近红外光谱技术在危重新生儿的应用及研究进展

近红外光谱(near infrared spectrocopy, NIRS)技术是一种无创的可靠的可实时监测组织血氧饱和度的技术。对在重症监护病房中危重新生儿进行多部位脑和躯体氧饱和度监测, 能够评估危重新生儿局部组织氧合和器官灌注。本文首先简单介绍了NIRS技术的发展历史、基本原理和有效监测部位。其次, 论述了NIRS技术近年来在危重新生儿如复杂的先天性心脏病术后。新生儿缺氧缺血性脑病、呼吸暂停与心律失常、新生儿脑室周围/脑室内出血、新生儿呼吸窘迫综合征、坏死性小肠结肠炎、新生儿急性肾损伤、早产儿红细胞输注等的应用和发展状况, 最后简单的对NIRS技术的未来应用前景进行了讨论。NIRS技术最初主要用于新生儿脑损伤和心脏手术后脑氧饱和度的监测, 来评估大脑氧合和灌注, 早期发现新生儿脑损伤和心脏手术后相关并发症, 从而早期干预治疗。现在NIRS技术在新生儿的各个领域均有涉及, 通过监测不同部位如脑部、肾脏、肠道、肝脏的氧饱和度, 有针对性的预测相关疾病、判断疾病的严重程度和手术的可行性, 从而降低疾病的发生率和死亡率, 改善新生儿预后和生活质量。在未来, 需要在不同部位、不同年龄段的新生儿开展更多的研究, 来促进新生儿其他疾病如极低出生体重儿喂养不耐受、新生儿体外循环后低心输出量综合征等的早期诊断和治疗, 缩短新生儿喂养进程, 保护心肺功能。 

Application and research progress of near infrared spectroscopy in critically ill neonates

Near infrared spectroscopy (NIRS) is a noninvasive and reliable technique for real-time monitoring of tissue oxygen saturation. Monitoring of multi-site brain and somatic oxygen saturation in intensive care unit can evaluate local tissue oxygenation and organ perfusion in critically ill newborns. Firstly, this paper briefly introduces the development history, basic principle and monitoring position of NIRS technology. Secondly, this paper discusses the development and application of NIRS technology in neonatal critical diseases such as complex congenital heart disease, neonatal hypoxic-ischemic encephalopathy, apnea and arrhythmia, neonatal periventricular/intraventricular hemorrhage, neonatal respiratory distress syndrome, necrotizing enterocolitis, neonatal acute kidney injury, erythrocyte infusion in premature infants, etc. Finally, the future application of NIRS technology is briefly discussed. NIRS technique was initially used to monitor brain oxygen saturation after neonatal brain injury and cardiac surgery to assess brain oxygenation and perfusion, early detect neonatal brain injury and related complications after cardiac surgery thus early intervention. NIRS technology is now involved in all areas of the newborn, by monitoring oxygen saturation in different parts of the brain, kidney, intestine, liver, targeted prediction of related diseases, judging the severity of the disease and the feasibility of surgery, so as to reduce the incidence and mortality of the disease and improve the prognosis and quality of life of newborns. In the future, we need to carry out more studies in different parts and different ages of neonates, to promote the early diagnosis and treatment of other neonatal diseases, such as very low birth weight infants feeding intolerance neonatal low cardiac output syndrome after cardiopulmonary bypass, shorten the process of neonatal feeding, and protect cardiopulmonary function.