胎粪吸入综合征新生儿脑组织氧饱和度的研究

Regional cerebral oxygen saturation in neonates with meconium aspiration syndrome

摘要:

目的：探讨胎粪吸入综合征(MAS)不同时相对新生儿局部脑组织氧饱和度(regionaloxygensatu-ration,rSO2)的影响因素及合并缺氧缺血性脑病时脑组织氧饱和度变化的意义。方法：根据MAS的临床表现分为无症状型、普通型、重型。应用TSNIR-3无创组织氧监测仪,测定其出生后1,3,5,7d时的脑组织氧饱和度变化,并与正常足月新生儿进行比较。结果：MAS无症状型与正常对照组的rSO2在出生后第1天(58.37±4.12vs60.43±2.85)、第3天(57.76±2.33vs60.17±3.46)比较差异有显著性(P<0.05);MAS普通型、重型生后的第1,3,5天时脑组织rSO2明显降低,MAS重型、普通型与无症状型、正常对照组的rSO2在出生后第1,3,5天比较差异有显著性(P<0.05)。MAS合并轻度HIE组与中~重度HIE组比较,rSO2在发病的第1天差异无显著性意义(P>0.05),第2,3,5天比较(57.60±3.60vs53.36±4.48;55.60±2.35vs51.36±3.20;56.80±2.78vs53.22±5.10)差异均有显著性意义(P<0.05)。结论：MAS患儿在生后的不同时相脑组织rSO2受到不同程度的影响,缺氧的加重和持续时间增加可使脑氧合功能进一步损害。

Abstract:

OBJECTIVE: This study examined the changes of regional cerebral oxygen saturation (rSO_ 2 ) by noninvasive near infrared spectrophotometry in neonates with meconium aspiration syndrome (MAS). METHODS: Seventy-three full neonates with MAS were divided into three groups by respiratory symptoms: asymptomatic group (group 1, n=38), common group (group 2, n=28) and severe group (group 3, n=7). Near infrared spectrophotometry was used to measure the cerebral rSO_ 2 on days 1, 3, 5 and 7 after birth. Thirty healthy full-term newborns served as the Control group. RESULTS: The cerebral rSO_ 2 of group 1 decreased significantly compared with that of the Control group between days 1 and 3 (P<0.05). The cerebral rSO_ 2 of group 2 or group 3 was significantly lower than that of group 1 and the Control group on days 1, 3 and 5 (P<0.05). The MAS patients with mild hypoxic-ischemic encephalopathy (HIE) had significantly higher brain rSO_ 2 levels than those with medium or severe HIE on days 2, 3 and 5 (P<0.05). CONCLUSIONS: The cerebral rSO_ 2 decreased in neonates with MAS. The values for rSO_ 2 correlate with the severity of HIE in MAS patients.