极/超低出生体重儿生后早期腹部局部组织氧饱和度变化趋势的前瞻性研究

Changing trend of abdominal regional oxygen saturation in very/extremely low birth weight infants in the early postnatal stage: a prospective study

摘要:

目的 探讨极/超低出生体重儿（very/extremely low birth weight infant，VLBWI/ELBWI）出生后的腹部局部组织氧饱和度（abdominal regional oxygen saturation，A-rSO₂）变化趋势。 方法 选取2019年9月至2021年5月在新生儿重症监护室住院的VLBWI/ELBWI作为研究对象。利用近红外光谱技术，从出生后第1天开始每天监测A-rSO₂，共监测4周。并根据出生胎龄分为较低胎龄组（<29周组）及较高胎龄组（≥29周组），对两组VLBWI/ELBWI生后4周内的A-rSO₂进行比较分析。 结果 共纳入VLBWI/ELBWI 63例，其中<29周组30例，≥29周组33例。63例VLBWI/ELBWI生后2周内A-rSO₂呈现波动变化：生后第1天为最低值（47.9%），后逐渐升高，第4天达最高峰（67.4%），第5~9天逐渐下降，然后再次上升，至出生2周后趋于稳定。≥29周组出生后第1周及第2周A-rSO2均高于<29周组，差异有统计学意义（P<0.05）。出生第3周及第4周两组A-rSO₂均值比较差异无统计学意义（P>0.05）。 结论 VLBWI/ELBWI的A-rSO₂在出生后最初2周随日龄增加存在波动变化，2周后趋于稳定；生后2周内的A-rSO₂与胎龄相关。

Abstract:

Objective To study the changing trend of abdominal regional oxygen saturation (A-rSO2) in very/extremely low birth weight (VLBW/ELBW) infants after birth. Methods The VLBW/ELBW infants who were admitted to the neonatal intensive care unit from September 2019 to May 2021 were enrolled as subjects. Near-infrared spectroscopy was used to monitor A-rSO2 since day 1 after birth for 4 weeks. According to gestational age, the infants were divided into a low gestational age (<29 weeks) group and a high gestational age (≥29 weeks) group. The two groups were compared in terms of A-rSO2 within 4 weeks after birth. Results A total of 63 VLBW/ELBW infants were enrolled, with 30 infants in the <29 weeks group and 33 in the ≥29 weeks group. A-rSO2 fluctuated within the first 2 weeks after birth in the 63 infants and had the lowest level of 47.9% on day 1 after birth and then gradually increased, reaching the peak level of 67.4% on day 4; it gradually decreased on days 5-9, then gradually increased, and became relatively stable 2 weeks after birth. The ≥29 weeks group had significantly higher A-rSO2 than the <29 weeks group at weeks 1 and 2 after birth (P<0.05), while there was no significant difference in A-rSO2 between the two groups at weeks 3 and 4 after birth (P>0.05). Conclusions In infants with VLBW/ELBW, A-rSO2 fluctuates within the first 2 weeks after birth and then gradually becomes stable. A-rSO2 is associated with gestational age within 2 weeks after birth.