近红外光谱测定技术对缺氧新生儿脑反应性功能检测的意义

USE OF NEAR INFRARED SPECTROSCOPY FOR DETECTION OF BRAIN RESPONSIVE-FUNCTION CHANGES AFTER HYPOXIA IN NEONATES

为评价近红外光谱测定技术（NIRS）对正常及围产期缺氧新生儿脑反应性功能的检测意义，本文检测了54例不同程度缺氧新生儿及33例正常新生儿安静状态下脑活动时氧合状态和听觉刺激后脑活动增强时氧合状态反应性变化。结果显示出正常新生儿稳态的脑功能活动及对刺激良好的反应状态；重度缺氧后72小时内脑反应性功能状态明显减弱，尤以生后24小时最差，与临床明显中枢神经系统症状及心血管系统损害相平行。提示NIRS可用于新生儿生理及病理状态下脑反应性功能的检测，能更早期、直接、敏感地反应脑损伤程度并估价预后。

To evaluate the diagnostic value of Near Infrared Spectroscopy(NIRS) for detection of brain responsive-function changes after neonatal hypoxia,we observed changes of intracranial oxygenation in response to sound stimuli in 33 normal newborns and 54 newborns with vari ous degrees of hypoxia using NIRS. We found that normal newborns showed steady cerebral oxygenation under quiet states and an increase of cerebral oxygenation after sound stimula tion. However,newborns with severe hypoxia showed inhibited brain activities with little in tracranial oxygenation changes in response to sound stimuli within 72hs of hypoxia,especially at 24h. The inhibited brain functioning was closely associated with the occurrence of central nerve system symptoms and cardiovascular injury. Our findings suggest that NIRS can be used as a diagnostic tool for detection of brain responsive-function changes,giving early di rect and sensitive clues to the severity of brain damage and long-term prognosis