近红外光谱监测在先天性心脏病患儿围术期应用的研究进展

Research progress on the application of near-infrared spectroscopy monitoring in the perioperative period of children with congenital heart disease

先天性心脏病是儿童最常见的心脏病,大部分先天性心脏病患儿需及时进行手术治疗矫正畸形。然而,术后脑损伤和神经发育不良一直是心肺转流下先天性心脏病手术后常见的神经系统并发症,严重影响患儿的预后。有效的监测手段对于积极预防、尽早发现和及时处理神经系统并发症至关重要。应用近红外光谱(NIRS)监测局部脑组织氧饱和度(rScO 2),或联合其他脑神经功能监测手段进行多模式监测,有助于及时发现脑缺血缺氧不良事件,进而循序调整影响因素进行干预,有利于降低术后神经损伤的发生率,改善患儿预后。本文就NIRS的原理、影响因素及其在先天性心脏病患儿围术期单独应用和与其他监测方法联合应用进行综述,旨在为先天性心脏病患儿围术期脑神经功能监测提供参考。

Congenital heart disease is the most common type of heart disease in children,and most patients require prompt surgery.However,postoperative brain injury and adverse neurodevelopmental outcomes have always been common neurological complications after congenital heart surgery,which seriously affect the prognosis of children.Effective surveillance is essential for proactive prevention,early detection and timely management of neurological complications.The use of near-infrared spectroscopy(NIRS)for monitoring regional cerebral oxygen saturation(rScO 2),or multimodal monitoring combined with other brain nerve function monitoring methods,can help to detect adverse events of cerebral ischemia and hypoxia in time,and then adjust the influencing factors for intervention,which may be beneficial to reduce the incidence of postoperative nerve injury and improve the prognosis of children.This article reviews the principle and influencing factors of NIRS and its application in the perioperative period of children with congenital heart disease and in combination with other monitoring methods,aiming to provide the basis for perioperative neurological function monitoring in children with congenital heart disease.