近红外光谱技术产时监测宫内缺氧性脑损伤的研究.docVIP

近红外光谱技术产时监测宫内缺氧性脑损伤的研究( 　 叶贞志 谢小强 韩玉昆 杨晓光 郭亮 苏国云 【摘要】 目的　探讨近红外光谱技术产时监测宫内缺氧性脑损伤的价值,为临床评价脑损伤提供客观、量化依据。 方法　对46例宫内窘迫新生儿，根据出生后是否合并新生儿缺氧缺血性脑病（HIE）分为HIE组及无HIE组，应用近红外光谱技术测定其脑组织氧饱和度(rSO2 ),并与对照组比较。ROC曲线评价脑组织rSO2 对HIE的诊断价值。 结果　HIE组患儿产程中胎头剥露时及生后5min两个时间点脑组织rSO2（37.9%±4.8%；52.6%±4.5%）均明显低于正常对照组（45.9%±4.6%；59.6%±4.4 %）及宫内窘迫无合并HIE组（44.1%±3.1%；57.6%±3.5%）新生儿(P 0. 01)。各组新生儿产程中胎头剥露时脑组织rSO2与脐动脉血气血氧饱和度间，均呈良好正相关（P0.0）valuation of intrapartum Hypoxic-Ischemic Cerebral Injury using near infrared spectroscopy.YE Zhen-zhi*, XIE Xiao-qiang, HAN Yu-kun, et al. *Department of Pediatrics，Gongming Hospital of Guangming New District，Shenzhen 518106; Guangdong，China. 【Abstract】 : Objective　To discuss the significance of the evaluation of intrapartum Hypoxic-Ischemic Cerebral Injury using near infrared spectroscopy (NIRS) , and to provide a method to evaluate brain damage objectively and quantitatively. Methods　A total of 46 Newborn Infants with Fetal Distress were divided into hypoxic ischemic encephalopathy( HIE) group and non- HIE group. Using NIRS, the brain regional oxygen saturation in these patients were measured , comparing with the control group. Evaluation of brain oxygenation in the diagnosis of HIE by receiver operating characteristic curve. Results　at time points of fetal head revealing and five minutes after born , The HIE group showed decreased brain oxygenation（37.9%±4.8%；52.6%±4.5%）, Compare with control group（45.9%±4.6%；59.6%±4.4 %）and non- HIE group（44.1%±3.1%；57.6%±3.5%）Newborn Infants(P0.01) . The brain oxygenation was positively correlated with the oxygen saturation of umbilical artery blood gas analysis in all group(P0.01).The sensitivity and specificity of assessing the HIE by brain oxygenation at fetal head revealing was 64 % and 93% respectively. Conclusions The brain oxygen saturation obtained by NIRS could be used to evaluate the brain oxygena, and may be useful in predicting whether Newborn Infants with Fetal Distress have HIE or not .