近红外光谱测定技术在窒息新生儿脑血流及氧合代谢变化测定的应用

Determination of near infrared spectroscopy in the application of asphyxia newborn cerebral blood flow and oxygen metabolism changes

目的分析研究使用近红外光谱测定技术在窒息新生儿脑血流及氧合代谢变化测定的应用效果。方法选择2013年3月～2013年10月我院妇产科内出生的足月窒息新生儿45例作为本次实验的研究对象，根据患者的窒息严重程度分为轻度窒息、重度窒息两组。其中实验组23例，包括轻度、重度窒息为11、12例，使用NIRS检测脑血流；对照组22例，包括轻、重度窒息各11例，使用头颅CT检测。观察比较轻重度患者脑血流及氧合代谢及两种方法的检查结果。结果轻重度窒息新生儿脑血容量tHb轻度窒息出生后12h为（0．16±0．07）μmol／L、24h为（1．82±0．52）μmol／L、72h为（3．23±0．61）μmol／L；重度为（0．63±0．12）μmol／L、（3．31±0．56）μmol／L、（2．61±1．65）μmol／L和脑组织灌注HbD轻度为：（2．1l±0．56）μmol／L、（3．38±0．44）μmol／L、（4．45±0．97）μmol／L；重度为（4．27±1．02）μmol／L、（4．94±0．71）μmol／L、（3．57土1．34）μmol／L比较差异有统计学意义（P〈0．05）。结论使用近红外光谱测定技术在窒息新生儿脑血流及氧合代谢变化中具有较好的应用效果，可以更好地判断新生儿的窒息严重程度，是一种较好的方法。

Objective To analyze and study the application effect of determination of near infrared spectroscopy in asphyxia newborn cerebral blood flow and oxygen metabolism changes. Methods 45 full-term asphyxia newborns who were born in the obstetrics and gynecology department of our hospital from March 2013 to October 2013 were selected as the research objects, which were divided into the mild asphyxia group and severe asphyxia group according to the patient＇ s severity of asphyxia. Of which 23 patients in the experimental group which included 11 mild asphyxia patients and 12 severe asphyxia patients were given the cerebral blood flow detection by using NIRS; While 22 cases in the control group which included 11 mild asphyxia patients and 11 severe asphyxia patients were given the cerebral blood flow detection by using the cerebral CT scan. The cerebral blood flow and oxygen metabolism examination results of mild, severe asphyxia patients by using the two methods were observed and compared. Results The cerebral blood volume tHb in the mild asphyxia newborns at 12h, 24h, 72h after birth was（0.16 ± 0.07）μ mol/L,（1.82± 0.52）μmol/L, （3.23 ± 0.61）μ mol/L respectively, while that in the severe asphyxia newborns was （0.63 ± 0.12）μ mol/L,（3.31 ± 0.56） μ mol/L,（2.61± 1.65）μ mol/L respectively; The cerebral tissue perfnsion HbD in the mild asphyxia newborns at 12h, 24h, 72h after birth was（2.11 ± 0.56）μ mol/L,（3.38 ±0.44） μ mol/L,（4.45± 0.97） μ mol/L respectively, while that in the severe asphyxia newborns was （4.27± 1.02） μ mol/L,（4.94 ± 0.71） μmol/L,（3.57 ± 1.34） μmol/L respectively. The differences were statistically significant in the cerebral blood volume tHb and cerebral tissue perfusion HhD at 12h, 24h, 72h after birth between the mild and severe asphyxia newborns（P 〈 0.05）. Conclusion Determination of near infrared spectroscopy has better effect in the application of asphyxia newborn cerebral blood flow and oxygen metabolism changes, can better judge the severity of asphyxia newborn, and is a kind of better method.