高原地区新生儿脉搏血氧饱和度的分布特点

Distribution characteristics of neonatal pulse oximetry in high altitude areas

目的:了解高原地区新生儿脉搏血氧饱和度(SpO 2)的分布特点。方法:选择2016年9月至2017年12月在兰州大学第一医院及敦煌、酒泉、静宁、临洮各分院出生的健康、足月新生儿为研究对象,预先排除重症先天性心脏病或肺部疾病患儿,测定出生12 h内新生儿不同部位的SpO 2。对同一地区不同性别新生儿不同部位SpO 2及不同地区相同部位SpO 2进行统计比较,并获得不同海拔地区新生儿任意下肢与右上肢SpO 2值及两值差百分位数分布特点。结果:同一地区不同性别新生儿任意下肢与右上肢SpO 2值及两值差比较差异均无统计学意义(均P>0.05)。不同海拔地区任意下肢、右上肢SpO 2值中位数(M)及两值差比较差异有统计学意义(均P<0.05);进一步两两比较结果显示,兰州地区(海拔1520 m)右上肢的SpO 2为96%,低于敦煌(海拔1138 m,M=97%)、酒泉(海拔1481 m,M=97%)地区,两值差M值(M=2%)高于敦煌和酒泉(M=1%),差异均有统计学意义(均P<0.05);静宁地区(海拔1668 m)任意下肢(M=96%)、右上肢(M=96%)SpO 2值低于敦煌、酒泉地区,差异均有统计学意义(均P<0.05);临洮地区(海拔1883 m)任意下肢(M=96%)、右上肢(M=96%)的SpO 2M值低于敦煌、酒泉地区,两值差M值(M=2%)高于敦煌和酒泉,差异均有统计学意义(均P<0.05)。当海拔低于1500 m时,SpO 2值为97%,P3~P97为93%~100%;任意下肢与右上肢两值差的M值为1%,P3~P97为0~4%。当海拔高于1500 m时,SpO 2M值为95%~96%,P3~P97为89%~100%;任意下肢与右上肢两值差的SpO 2M值为1%~2%,P3~P97为0~9%。结论:不同海拔地区新生儿任意下肢与右上肢SpO 2数及两值差百分位数分布特点有所不同。

Objective To understand the distribution characteristics of pulse oxygen saturation(SpO2)in the high altitude areas.Methods From September 2016 to December 2017,all healthy and full-term live births in the First Hospital of Lanzhou University and Dunhuang,Jiuquan,Jingning and Lintao branches were selected as the research objects.Critical congenital heart disease or pulmonary diseases were excluded in advance.SpO2 in different parts of newborns within 12 hours of birth was measured.Statistical comparisons of SpO2 in different parts of male and female neonates in the same area and SpO2 in different parts of different regions were made.The number of SpO2 and the distribution of percentile difference between the lower limbs and the right upper limb of newborns at different altitude areas were obtained.Results There were no significant difference between male and female infants in SpO2 value at any lo-wer extremity and right upper extremity and the difference value in the same area(all P>0.05).There were significant differences in the median(M)values of SpO2 and the M value of the difference between the two values of any lower limb and right upper limb at different altitudes(all P<0.05).The results showed that the M value of SpO2 of the right upper limb(M=96%)in Lanzhou(1520 m above sea level)was lower than that in Dunhuang(1138 m above sea level,M=97%)and Jiuquan(1481 m above sea level,M=97%),and the M value of the difference between the two values(M=2%)was higher than that in Dunhuang and Jiuquan(M=1%)(P<0.05).The M of SpO2 of any lower limb(M=96%)and right upper limb(M=96%)in Jingning areas(1668 m above sea level)were lower than that in Dunhuang and Jiuquan area(all P<0.05).The median value of SpO2 of any lower limb(M=96%)and right upper limb(M=96%)in Lintao area(1883 m above sea level)was lower than that in Dunhuang and Jiuquan areas,and the M value of the difference between the two values(M=2%)was higher than that in Dunhuang and Jiuquan(all P<0.05).When the altitude was lower than 1500 m,the M value of SpO2 was 97%,P3-P97 was 93%-100%;the M value of the difference between any lower limb and right upper limb was 1,and P3-P97 was 0-4.When the altitude was higher than 1500 m,the M value of SpO2 was 95%-96%,P3-P97 was 89%-100%;the M value of SpO2 of an lower limb and right upper limb was 1%-2%,and P3-P97 was 0-9%.Conclusions The SpO2 number and percentage distribution of the difference between any lower limb and right upper limb of newborns at different altitudes are different.