新生儿窒息复苏后脑组织的氧合血红蛋白的变化

目的探讨新生儿窒息复苏后在音乐刺激情况下脑组织的氧合血红蛋白的变化，观察窒息复苏后患儿的早期脑反应性。方法对我院2005年至2006年窒息复苏后的新生儿39例分别在12～24h、第2d～3d、第5-7d用近红外光谱测定技术测安静状态及音乐刺激后脑组织的氧合血红蛋白，分别按窒息程度分组，并进行组间比较。结果与正常对照组、轻度窒息组比较，重度窒息组脑组织的氧合血红蛋白在安静状态下及音乐刺激后无明显变化，P〈0．01。结论脑组织的氧合血红蛋白有助于了解新生儿窒息后的脑反应性。     

高原地区动态监测健康新生儿出生1～30 min血氧饱和度变化意义及对用氧指导价值

目的 探究高原地区动态监测健康新生儿出生1～30 min血氧饱和度(SpO₂)变化意义及对用氧指导价值。方法 选取2019年1月至2021年6月高原地区健康新生儿212例,均采用脉氧饱和度监测仪测定出生1～30minSpO₂水平变化。结果 212例健康新生儿出生1 min、2 min、3 min、4 min、5 min、10 min、30 min任意下肢、右上肢SpO₂水平呈逐渐升高趋势;随着海拔升高,健康新生儿出生后相同时间点任意下肢、右上肢SpO₂水平呈下降趋势(P<0.05);随着出生时间延长,相同海拔地区健康新生儿任意下肢、右上肢SpO₂水平呈升高趋势(P<0.05);海拔·时间点交互作用差异有统计学意义(P<0.05);健康新生儿出生1 min、2 min、3 min、4 min、5 min、10 min任意下肢、右上肢SpO₂水平与海拔呈负相关(P<0.05);相同海拔地区不同性别、分娩方式健康新生儿出生1 min、2 ...     

近红外光谱技术监测硫酸镁对重症手足口病合并心肺衰竭患儿脑氧合水平的影响

目的使用近红外光谱技术(NIRS)监测脑血氧代谢, 探讨硫酸镁对重症手足口病(HFMD)合并心肺衰竭患儿脑氧合水平的影响。方法选取2015年3月至2018年3月郑州大学附属儿童医院收治的重症HFMD合并心肺衰竭患儿46例为研究对象, 随机分为观察组和对照组, 每组23例。对照组采用对症支持治疗, 观察组在对症支持治疗的基础上予硫酸镁静脉滴注, 连续治疗5 d。监测治疗后不同时点两组局部脑氧饱和度(rScO2)、血乳酸、上腔静脉血氧饱和度(ScvO2)水平, 记录两组治疗前后振幅整合脑电图(aEEG)改变。结果治疗前对照组aEEG异常19例, 观察组aEEG异常20例, aEEG异常率组间比较差异无统计学意义(P>0.05)。治疗后对照组aEEG恢复正常8例(42.1%), 观察组aEEG恢复正常15例(75.0%), 观察组aEEG恢复正常率显著高于对照组(χ2=4.36, P=0.037)。入院后72 h、96 h对照组rScO2显著低于观察组(t=-2.90、-2.94, 均P<0.05), 入院后24 h、48 h、72 h观察组血乳酸较对照组显著下降(t=2.43、...     

颈内静脉球血氧饱和度监测的临床应用

颈内静脉球血氧饱和度(jugular venous bulb oxygen saturation,SjvO2)监测可及早发现脑氧供需的变化,尽早治疗以减轻脑组织的缺血缺氧性损伤.在神经外科手术、体外循环(cardiopulmonary bypass,CPB)和特殊体位手术中应用广泛,与脑组织氧分压(partial ox...     

主动脉弓手术停循环与脑灌注期间脑区域氧饱和度监测

目的:明确深低温停循环(DHCA)与脑灌注相结合进行主动脉弓手术期间脑区域氧饱和度监测(rSO2)的价值.方法:28位病人的rSO2被监控,数据被统计分析.结果:DHCA的平均停循环时间是(59±17.1)min,外科手术的结果比较满意,住院期间死亡2例,死亡率(5.6%).虽然全部病人兼有脑灌注支持,rSO2在DHCA期间仍然逐渐下降,平均降到(47±9.7)%,在复温末期又恢复到它的最初水平.有2位病人rSO2降低最明显,在长达83和88min的DHCA之后rSO2分别从57%和56%下降到27%和29%,这2位病人最终发展永久的神经系统损害.我们同时考察了End-rSO2和△-rSO2两个参数,在DHCA期间,脑灌注的灌注流速和这两个参数都存在线性相关.结论:(1)尽管DHCA和一定方式脑灌注的结合能提供大脑更有效的保护,这种保护措施仍然有一个安全的时限;(2)NIRS能实时监控脑rSO2,可用于监测大脑保护是否充分,有利于DHCA下脑灌注参数的凋整.     

急性重复低氧对小鼠脑组织血氧饱和度、线粒体功能以及ATP水平的影响

目的： 探讨急性重复低氧对脑组织血氧饱和度与线粒体功能的影响。方法: 将BALB/c小鼠置于低氧密闭罐中，通过小鼠呼吸消耗罐内氧造成罐内低氧，以小鼠出现喘呼吸为低氧耐受极限，然后将小鼠转到另一低氧密闭罐中，依此类推，连续进行5次低氧。记录小鼠每次的缺氧耐受时间、局部脑组织血氧饱和度，测定每次低氧暴露结束时的脑组织的线粒体复合体I活性和ATP含量。结果: 小鼠的缺氧耐受时间随缺氧暴露次数增加而显著延长。脑组织血氧饱和度在第1、2次缺氧暴露时急剧下降，但在第3、4、5低氧暴露时先小幅度下降再逐渐恢复至正常水平，然后再缓慢降低。脑组织线粒体复合体I的活性随着缺氧次数的增加逐渐被抑制，ATP含量在第1次低氧暴露结束时低于正常水平，在第3、5次低氧暴露结束时高于正常水平。结论: 急性重复低氧导致脑组织血氧饱和度降低的速度减慢、线粒体功能抑制以及脑组织ATP水平增高，后者很可能是动物脑组织耐缺氧能力增强的重要机制。     

新生儿疾病筛查信息管理系统的设计和开发

目的为进一步在浙江省范围内推广新生儿疾病筛查,提高新生儿疾病筛查管理。方法开发了《浙江省新生儿疾病筛查信息管理系统》,为浙江省新生儿疾病筛查中心提供筛查的技术服务和信息管理。结果提高了浙江省新生儿疾病筛查中心的效率,并对患儿加强了治疗和随访管理。结论加强了对新生儿疾病筛查的监督和管理,促进了新生儿疾病筛查工作发展。     

不同胎龄新生儿必需脂肪酸水平变化的研究

必需脂肪酸及其衍生物长链多不饱和脂肪酸（LongchainpolyunsaturatedfattyacidLCP）在婴儿营养上的重要性正日益受到人们重视。研究表明，LCP与胎儿、婴儿中枢神经系统发育密切相关（1），国外已有一定的研究，国内研究尚少。本文研究测定了58例不同胎龄新生儿出生时脐血中必需脂肪酸水平，现报告如下。对象与方法选择本院妇产科正常健康产妇分娩的不同胎龄新生儿，其中28－37周者34例，37－41周者24例，体重1750－4150g．Apgar评分≥8分，无先天遗传代谢性疾病。于分娩后取脐静脉血2ml，置于含有肝素的抗凝管中，轻轻摇匀，低温离心取…     

新生儿疾病筛查工作的管理

在施实新生儿疾病筛查工作的过程中，针对不断出现的难点和问题，通过抓培训，促进新生儿疾病筛查（“新筛”）网络人员专业技能的掌握；做好“新筛”知识宣传，提高群众自觉参与新生儿疾病筛查的意识；多环节联动作用，提高了“新筛”采血率；相关账册资料的建立，使工作程序环环相扣；相应的对策和措施，强化了管理的途径，从而促进了新生儿疾病筛查工作的正常开展，管理质量的提高。     

极量强度运动NIRS组织氧检测最佳耦合参数的仿真研究

目的 在介绍近红外光谱法（near-infrared spectroscopy,NIRS）检测组织氧相对量原理的基础上,建立极量强度运动中用以仿真光子迁移的人体股四头肌三层光学模型（皮肤、脂肪和肌肉）.方法 利用MATLAB强大的数据分析和图形显示功能,在C#中结合MATLAB引擎技术,开发Monte Carlo仿真应用程序.结果 利用该应用程序,研究了极量强度运动领域近红外组织氧检测法中光源探测器最优间距的确定问题,给出光源探测器最优间距选取的经验公式.结论 该仿真研究在极量强度运动领域具有一定应用价值.     

脑血氧饱和度的无创伤测量和脑思维功能的研究

利用近红外光谱法（NIRS）,根据广义郎伯特一比尔定律（Lambert-Beer)可以实现活体脑血氧浓度的无创伤测量,在本论文中,通过将脑血氧饱和度和脑功能相结合的实验,讨论研究高级脑功能的可能性,利用事件相关实验可以检测脑的思维功能,实验结果的时域曲线判别不大,然而,利用DFT,五个被实验者的实验数据表明20Hz和40Hz频率的信号与困难的智力工作有关,实验结果表明了利用在频域范围内分析脑血氧饱和度的方法来进行脑功能研究的可行性。     

A comparison of pulse oximetry and cerebral oxygenation in children with severe sleep apnea–hypopnea syndrome: a pilot study

Near infrared spectroscopy (NIRS) has been used to assess the impact of obstructive sleep apnea–hypopnea syndrome (OSAHS) on cerebral oxygenation. However, the relationship between the variations in the cerebral tissue oxygen saturation (ΔTOI) and pulse oximetry (ΔSpO₂) has not been assessed in children with OSAHS. Consecutive clinically stable children with severe OSAHS [apnea–hypopnea index (AHI) >15 events h⁻¹] diagnosed during a night‐time polygraphy with simultaneous recording of cerebral oxygenation with NIRS (NIRO‐200NX, Hamamatsu Photonics KK) were included between September 2015 and June 2016. Maximal ΔSpO₂ (SpO₂ drop from the value preceding desaturation to nadir) and concomitant variations in transcutaneous carbon dioxide (ΔPtcCO₂), maximal ΔTOI and maximal variations in cerebral oxygenated (O₂Hb) and deoxygenated (HHb) haemoglobin were reported. The relationships between ΔSpO₂, ΔPtcCO₂ and ΔTOI, ΔO₂Hb and ΔHHb were investigated. The data from five children (three boys, aged 9.6 ± 6.7 years, AHI 16–91 events h⁻¹) were analysed. Strong correlations were found between ΔSpO₂ and ΔTOI (r = 0.887, P < 0.001), but also with ΔO₂Hb and ΔHHb with a particular pattern in the youngest child with a dark skin pigmentation. Mean ΔSpO₂ was 20 ± 17% and mean ΔTOI was 8 ± 7%. Maximal ΔSpO₂ of approximately 70% were coupled with ΔTOI of no more than 35%. ΔPtcCO₂ correlated only weakly with the cerebral oxygenation indexes. This pilot study shows a strong relationship between pulse oximetry and cerebral oxygenation in children with OSAHS, with lower changes in TOI compared to SpO₂. Future studies should address the clinical impact of respiratory events on cerebral oxygenation and its consequences.     

Cerebral oxygenation and cerebral oxygen extraction in the preterm infant: the impact of respiratory distress syndrome

Haemodynamic factors play an important role in the etiology of cerebral lesions in preterm infants. Respiratory distress syndrome (RDS), a common problem in preterms, is strongly related with low and fluctuating arterial blood pressure. This study investigated the relation between mean arterial blood pressure (MABP), fractional cerebral oxygen saturation (ScO₂) and fractional (cerebral) tissue oxygen extraction (FTOE), a measure of oxygen utilisation of the brain, during the first 72 h of life. Thirty-eight infants (gestational age < 32 week) were included, 18 with and 20 without RDS. Arterial oxygen saturation (SaO₂), MABP and near infrared spectroscopy-determined ScO₂ were continuously measured. FTOE was calculated as a ratio: (SaO₂–ScO₂)/SaO₂. Gestational age and birth weight did not differ between groups, but assisted ventilation and use of inotropic drugs were more common in RDS infants (P<0.01). MABP was lower in RDS patients (P<0.05 from 12 up to 36 h after birth), but increased in both groups over time. ScO₂ and FTOE were not different between groups over time, but in RDS infants ScO₂ and FTOE had substantial larger variance (P<0.05 at all time points except at 36–48 h for ScO₂ and P<0.05 at 12–18, 18–24, 36–48 and 48–60 h for FTOE). During the first 72 h of life, RDS infants showed more periods of positive correlation between MABP and ScO₂ (P<0.05 at 18–24, 24–36 36–48 48–60 h) and negative correlation between MABP and FTOE (P<0.05 at 18–24, 36–48 h). Although we found that the patterns of cerebral oxygenation and extraction in RDS infants were not different as compared to infants without RDS, we suggest that the frequent periods with possible lack of cerebral autoregulation in RDS infants may make these infants more vulnerable to cerebral damage.     

Oscillations in cerebral blood flow and cortical oxygenation in Alzheimer's disease

In Alzheimer's disease (AD) cerebrovascular function is at risk. Transcranial Doppler, near-infrared spectroscopy, and photoplethysmography are noninvasive methods to continuously measure changes in cerebral blood flow velocity (CBFV), cerebral cortical oxygenated hemoglobin (O₂Hb), and blood pressure (BP). In 21 patients with mild to moderate AD and 20 age-matched controls, we investigated how oscillations in cerebral blood flow velocity (CBFV) and O₂Hb are associated with spontaneous and induced oscillations in blood pressure (BP) at the very low (VLF = 0.05 Hz) and low frequencies (LF = 0.1 Hz). We applied spectral and transfer function analysis to quantify dynamic cerebral autoregulation and brain tissue oxygenation. In AD, cerebrovascular resistance was substantially higher (34%, AD vs. control: Δ = 0.69 (0.25) mm Hg/cm/second, p = 0.012) and the transmission of very low frequency (VLF) cerebral blood flow (CBF) oscillations into O₂Hb differed, with increased phase lag and gain (Δ phase 0.32 [0.15] rad; Δ gain 0.049 [0.014] μmol/cm/second, p both < 0.05). The altered transfer of CBF to cortical oxygenation in AD indicates that properties of the cerebral microvasculature are changed in this disease.     

Near‐infrared spectroscopy determined brain and muscle oxygenation during exercise with normal and resistive breathing

To elevate effects of carbon dioxide (CO₂) retention by way of an increased respiratory load during submaximal exercise (150 W), the concentration changes of oxy‐ (ΔHbO₂) and deoxy‐haemoglobin (ΔHb) of active muscles and the brain were determined by near‐infrared spectroscopy (NIRS) in eight healthy males. During exercise, pulmonary ventilation increased to 33 (28–40) L min^–1 (median with range) with no effect of a moderate breathing resistance (reduction of the pneumotach diameter from 30 to 14 and 10 mm). The end‐tidal CO₂ pressure (P_ETCO ₂) increased from 45 (42–48) to 48 (46–58) mmHg with a reduction of only 1% in the arterial haemoglobin O₂ saturation (S_aO ₂). During control exercise (normal breathing resistance), muscle and brain ΔHbO₂ were not different from the resting levels, and only the leg muscle ΔHb increased (4 (–2–10) μM , P < 0.05). Moderate resistive breathing increased ΔHbO₂ of the intercostal and vastus lateralis muscles to 6 ± (–5–14) and 1 (–7–9) μM (P < 0.05), respectively, while muscle ΔHb was not affected. Cerebral ΔHbO₂ and ΔHb became elevated to 6 (1–15) and 1 (–1–6) μM by resistive breathing (P < 0.05). Resistive breathing caused an increased concentration of oxygenated haemoglobin in active muscles and in the brain. The results indicate that CO₂ influences blood flow to active skeletal muscle although its effect appears to be smaller than for the brain.     

近红外光谱仪(NIRS)在心血管外科中的应用

采用近红外光谱仪进行脑功能监测是近几年发展起来的一个研究热点。本文对近红外光谱仪在心血管外科中的应用进行综述 ,并对其他脑功能监测手段进行比较 ,展示了近红外光谱仪的临床应用前景     

Human motor-cortex oxygenation changes induced by cyclic coupled movements of hand and foot

Near-infrared spectroscopy (NIRS) was used to assess human motor-cortex oxygenation changes in response to cyclic coupled movements of hand and foot. Using a highly sensitive NIRS instrument, we showed that it was possible to detect reproducible oxygenation patterns using single cycles (20 s) of easy and difficult association tasks. No significant differences in the time corresponding to the maximal changes in concentration of oxy- and deoxyhemoglobin ([O₂Hb] and [HHb], respectively) were found during easy and difficult association as well as cycles. Only [O₂Hb] showed a significantly higher value at the end of the difficult association during the first cycle. No significant differences were found for [O₂Hb] and [HHb] in the other cycles. We conclude that NIRS is a useful addition to functional magnetic resonance imaging in investigating the time course of cortical activation. Received: 9 October 1998 / Accepted: 13 August 1999     

Reliability of erector spinae oxygenation and blood volume responses using near-infrared spectroscopy in healthy males

The purpose of this investigation was to (1) describe the trends in oxygenation (OXY) and blood volume (BV) of the right and left paraspinal muscles during the Biering-Sorensen muscle endurance (BSME) test using near infrared spectroscopy (NIRS), and (2) assess the test-retest reliability of OXY and BV changes during the BSME in healthy males. Seventeen healthy males [age=28.4 (9.8) years, height=1.75 (0.05) m, body mass=82.7 (9.1) kg; mean (SD)] completed two BSME trials within 1 week. NIRS probes were placed bilaterally at lumbar 3. The test was performed with the subject in the prone position using the following protocol: 2 min baseline, BSME, and 4 min recovery. The delta and range values of OXY and BV were used for analysis. Acceptable intra-class correlations were observed for endurance time and all the NIRS variables at the point of fatigue and at each 10% segment of the BSME during the two trials. Bland-Altman plots confirmed the reproducibility of the bilateral NIRS responses of the paravertebral muscles. The BV responses were more reliable than the OXY responses during the two trials. The OXY and BV responses of the paravertebral muscles during static contractions can be measured reliably using NIRS. Future studies should focus primarily on BV for analysis.     

Effects of time pressure and precision demands during computer mouse work on muscle oxygenation and position sense

The present study investigated the effects of time pressure and precision demands during computer mouse work on muscle oxygenation and position sense in the upper extremity. Twenty-four healthy subjects (12 males and 12 females) performed a 45-min standardized mouse-operated computer task on two occasions. The task consisted of painting rectangles that were presented on the screen. On one occasion, time pressure and precision demands were imposed (more demanding task, MDT), whereas, on the other occasion, no such restraints were added (less demanding task, LDT). The order of the two task versions was randomized. Tissue oxygen saturation in the trapezius and extensor carpi radialis muscles was recorded throughout, and the position-matching ability of the wrist was measured before and after the tasks. In addition, measurements of autonomic nervous system reactivity and subjective ratings of tenseness and physical fatigue were obtained. Performance was measured in terms of the number of rectangles that were painted during the task. During MDT, oxygen saturation in extensor carpi radialis decreased (P<0.05) compared to LDT. These data were paralleled by increased electrodermal activity (P<0.05), skin blood flow (P<0.05), ratings of tenseness and fatigue (P<0.01), and increased performance (P<0.01) during MDT. Females exhibited lower oxygen saturation than males, during rest as well as during the computer tasks (P<0.01). Wrist repositioning error increased following LDT as compared to MDT (P<0.05). In conclusion, computer mouse work under time pressure and precision demands caused a decrease in forearm muscle oxygenation, but did not affect wrist position sense accuracy. We attribute our changes in oxygenation more to increased oxygen consumption as a result of enhanced performance, than to vasoconstriction.Presented in part at the 49th Nordiska Arbetsmiljömötet in Savonlinna Finland, August 25–27, 2003