近红外光谱技术在早期识别新生儿胃肠道疾病中的应用

doi:10.7499/j.issn.1008-8830.2311148

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摘要新生儿坏死性小肠结肠炎（necrotizing enterocolitis, NEC）是新生儿重症监护病房最常见的胃肠道疾病之一，进展迅速，病死率较高，肠道局部缺血缺氧是导致NEC的重要原因。喂养不耐受（feeding intolerance, FI）指不能耐受肠内营养而出现的一系列胃肠道表现，是目前新生儿最常见的临床问题之一，防治FI对提高新生儿存活率意义重大。近红外光谱是一种可用于床旁监测区域氧饱和度的临床工具，具有无创、可靠、可持续等优点，在测定肠道血液循环状况方面其可行性和安全性也得到了验证。早期识别肠道缺血并鉴别FI与NEC的前驱症状，预测NEC的发生，对减少肠道损伤及远期不良预后极为重要。近年来，对监测肠道组织氧饱和度和脑组织氧饱和度以早期识别FI与NEC的前驱症状相关临床事件有了新的研究进展。该文对近年来近红外光谱在监测新生儿NEC及FI区域血氧方面的应用进展及相关成果进行综述。

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	古丽佐合热·阿里木江
	努尔亚·热加甫

关键词 ：坏死性小肠结肠炎, 喂养不耐受, 近红外光谱, 局部组织氧饱和度, 新生儿

Abstract：Necrotizing enterocolitis (NEC) is one of the most common gastrointestinal diseases in neonatal intensive care units, characterized by rapid progression and a high mortality rate. Local intestinal ischemia and hypoxia are significant contributors to NEC. Feeding intolerance (FI), which refers to a range of gastrointestinal manifestations arising from the inability to tolerate enteral nutrition, is one of the most common clinical issues in neonates, and preventing and treating FI is crucial for improving neonatal survival rates. Near-infrared spectroscopy is a clinical tool that can be used at the bedside to monitor regional oxygen saturation. It is non-invasive, reliable, and sustainable, and its feasibility and safety in assessing intestinal blood circulation have been validated. Early identification of intestinal ischemia and differentiation of FI from precursor symptoms of NEC, as well as predicting the occurrence of NEC, are extremely important for reducing intestinal injury and adverse long-term outcomes. In recent years, there has been new research progress related to the monitoring of intestinal tissue oxygen saturation and cerebral oxygen saturation for the early identification of FI and precursor symptoms of NEC, and this article provides a review of these developments.

Key words： Necrotizing enterocolitis Feeding intolerance Near infrared spectroscopy Regional oxygen saturation Neonate

收稿日期: 2023-11-30

通讯作者: 努尔亚·热加甫，女，主任医师。Email：nerejep@163.com。 E-mail: nerejep@163.com

作者简介: 古丽佐合热·阿里木江，女，硕士研究生；

引用本文:

古丽佐合热·阿里木江,努尔亚·热加甫. 近红外光谱技术在早期识别新生儿胃肠道疾病中的应用[J]. 中国当代儿科杂志, 2024, 26(5): 523-528.

Gulizuohere· ALIMUJIANG,Nuerya· REJIAFU. Application of near-infrared spectroscopy in the early identification of neonatal gastrointestinal diseases[J]. CJCP, 2024, 26(5): 523-528.

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