摘要
目的新生儿坏死性小肠结肠炎手术前通过近红外光谱技术测定肠管血氧饱和度,与手术中坏死肠管部位及体积进行对照,通过数据分析测定肠管血氧饱和度最低部位与肠坏死部位符合程度来判定近红外光谱技术在肠坏死诊断中的价值,同时测定脑血氧饱和度判定新坏死性小肠结肠炎患儿脑血氧饱和度的变化。方法选取非肠道疾病新生儿30例作为对照组,确诊坏死性小肠结肠炎并保守治疗失败需要手术治疗的新生儿患儿27例。通过近红外光谱仪(脑血氧饱和度仪)分别测定对照组和手术组手术前上腹部、下腹部、左侧腹、右侧腹四个部位肠道血氧饱和度、脑血氧饱和度和外周血氧饱和度值,手术组手术中记录肠坏死部位和坏死肠管体积。分别比较两组数据,手术组统计四个测量部位最低值与手术中肠坏死部位的相符合程度占比,以及肠道血氧饱和度测量值与坏死肠管体积的关系。两组之间的对比采用t检验,手术前后符合程度用百分比,肠道血氧饱和度与坏死肠管体积关系用Pearson相关性分析。结果对照组与手术组之间同一部位之间肠道血氧饱和度、脑血氧饱和度以及血液血氧饱和度均有统计学差异(P<0.05),手术组内四个测量部位最低值与手术中肠坏死部位的相吻合程度占比85.2%,肠道血氧饱和度与坏死肠管体积有负线性相关。结论近红外光谱技术是测量肠管血氧饱和度和脑血氧饱和度的有效方法,对于肠道坏死程度有一定的评估价值,对于新生儿坏死性小肠结肠炎肠坏死的早期诊断有一定意义。
Objective To determine the value of near infrared spectroscopy(NIRS)in the diagnosis of neonatal necrotizing enterocolitis(necrotizing enterocolitis)by measuring the blood oxygen saturation of intestine by near infrared spectroscopy(NIRS)and comparing with the position and volume of necrotic bowel in operation changes of cerebral oxygen saturation in children with neonecrotizing enterocolitis.MethodsThirty cases of neonatal non intestinal diseases were selected as control group,27 cases of neonatal necrotizing enterocolitis were diagnosed and conservative treatment failed.The intestinal oxygen saturation,cerebral oxygen saturation and peripheral blood oxygen saturation of the upper abdomen,lower abdomen,left abdomen and right abdomen of the control group and the operation group were measured by near-infrared spectroscopy(cerebral oxygen saturation meter).The intestinal necrosis site and the volume of necrotic bowel were recorded in the operation group.The data of the two groups were compared.The proportion of the lowest value of the four measurement sites in accordance with the site of intestinal necrosis during operation,and the relationship between the measured value of intestinal blood oxygen saturation and the volume of necrotic bowel were calculated in the operation group.T-test was used to compare the two groups.The degree of compliance before and after operation was used as percentage.The relationship between intestinal oxygen saturation and necrotic bowel volume was analyzed by Pearson correlation.ResultsThere were significant differences in intestinal oxygen saturation,cerebral oxygen saturation and blood oxygen saturation between the same part of the control group and the operation group,P<0.05,with significant statistical difference.The lowest value of the four measurement sites in the operation group was 85.2%consistent with the necrotic site during operation,and there was a negative linear correlation between intestinal oxygen saturation and the volume of necrotic bowel.Conclusion Near infrared spect
作者
毛建雄
肖东
罗燕
张翅
王秀良
MAO Jian-xiong;XIAO Dong;LUO Yan;ZHANG Chi;WANG Xiu-liang(Department of General Surgery,Shenzhen Children′s Hospital,Shenzhen,Guang-dong 510028,China;Operation Room,Shenzhen Children′s Hospital,Shenzhen,Guangdong 510028,China)
出处
《岭南现代临床外科》
2020年第5期562-566,572,共6页
Lingnan Modern Clinics in Surgery
基金
深圳市科技计划项目(JCYJ20170303160036705)。
关键词
近红外光谱
新生儿坏死性小肠结肠炎
肠道血氧饱和度
脑血氧饱和度
near infrared spectroscopy
neonatal necrotizing enterocolitis
intestinaloxygen satura-tion
cerebral oxygen saturation
