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目的采用近红外光谱技术比较早产儿和健康足月儿出生12～24 h脑组织氧合状况。方法对2011年4-6月南京大学医学院附属鼓楼医院妇产科收治的77例足月儿和2011年11月-2012年3月南京医科大学附属儿童医院新生儿医疗中心收治的61例早产儿进行出生12～24 h的脑组织氧饱和度(rSO2)监测,比较2组新生儿的临床情况及其与rSO2的关系。结果 2组新生儿分娩方式和性别比较,差异均无统计学意义(Pa>0.05)。2组新生儿胎龄、出生体质量及窒息(Apgar评分)比较,差异均有统计学意义(Pa<0.05)。2组新生儿的检测时间和外周血氧饱和度比较,差异均无统计学意义(Pa>0.05)。健康足月儿组的rSO2为(62.70±3.75)%,早产儿组rSO2为(64.66±3.93)%,二组比较差异有统计学意义(P=0.003)。健康足月儿组的动脉血二氧化碳分压[p(CO2)]为(5.26±0.36)kPa,早产儿组为(6.04±1.18)kPa,二组比较差异有统计学意义(P=0.000)。结论早期早产儿与健康足月儿相比,出生12～24 h的rSO2偏高,可能与该时期早产儿的脑血流丰富,动脉血p(CO2)分压偏高及脑组织的局部缺氧有关。
Objective To compare the oxygenation of brain tissue between premature and healthy term born 12 ~ 24 h by near-infrared spectroscopy. Methods Totally 77 full-term infants admitted to Department of Obstetrics and Gynecology, Drum Tower Hospital Affiliated to Nanjing University Medical School from April to June 2011, and 61 preterm infants admitted to the Newborn Medical Center of Children’s Hospital Affiliated to Nanjing Medical University from November 2011 to March 2012 were enrolled in this study. Children were monitored for oxygen saturation (rSO2) 12 to 24 hours after birth. The clinical status of the neonates and the relationship with rSO2 were compared. Results There was no significant difference in the mode of delivery and gender between the two groups (Pa> 0.05). There were significant differences in gestational age, birth weight and apgar score between two groups (Pa <0.05). There was no significant difference between the two groups in neonatal detection time and peripheral oxygen saturation (Pa> 0.05). The rSO2 of healthy full-term infants was (62.70 ± 3.75)%, while that of premature infants was (64.66 ± 3.93)%. There was significant difference between the two groups (P = 0.003). The arterial carbon dioxide partial pressure (p (CO2)] of healthy full-term infants was (5.26 ± 0.36) kPa and that of premature infants was (6.04 ± 1.18) kPa. There was significant difference between the two groups (P = 0.000). Conclusions Compared with healthy full-term infants, the rSO2 of 12 ~ 24 hrs birth was significantly higher in early preterm infants than in healthy infants, which may be related to the cerebral blood flow rich in preterm infants, the high partial pressure of arterial blood p (CO2) and the lack of brain tissue Oxygen related.