危重新生儿生后早期血流灌注指数的变化及意义  

Change and Significance of Early Perfusion Index in Critically Ill Neonates

作　　者：刘雪琴 张卫星[2] 沈洁[2] 刘玉霞 唐成和[1] LIU Xue-qin;ZHANG Wei-xing;SHEN Jie;LIU Yu-xia;TANG Cheng-he(Department of Neonatology,the First Affiliated Hospital of Xinxiang Medical College,Weihui 453100,China;NICU,Xinxiang Central Hospital,Xinxiang 453000,China;Scientific Research and Education,Xinxiang Central Hospital,Xinxiang 453000,China)

机构地区：[1]新乡医学院第一附属医院新生儿科,河南卫辉453100 [2]新乡市中心医院NICU,河南新乡453000 [3]新乡市中心医院科教科,河南新乡453000

出　　处：《实用临床医学（江西）》2020年第7期44-47,51,共5页Practical Clinical Medicine

基　　金：河南省医学科技攻关计划联合共建项目(2018020926,LHGJ20191319)。

摘　　要：目的探讨危重新生儿生后早期血流灌注指数(PI)的变化及意义。方法将106例新生儿按胎龄分为足月组(胎龄>37周)51例与早产组(胎龄≤37周)55例,按新生儿危重病评分表(NCIS评分)将足月组、早产组新生儿分为A组(病情稳定)和B组(病情危重)2个亚组,其中足月A组30例、足月B组21例、早产A组34例、早产B组21例。对所有入组的新生儿在出生后第1—7天用MasimoRadical-7(USA)SpO2监测仪进行PI监测,并对各组数据进行组内和组间比较。结果足月组A、B 2个亚组新生儿生后1~7 d PI值呈逐渐上升的趋势,在生后1~4 d,足月B组PI值均显著低于足月A组(P<0.05或P<0.01),在生后5~7 d足月A、B组PI值比较差异无统计学意义(P>0.05);早产组A、B 2个亚组新生儿生后1~7 d PI值亦呈逐渐上升的趋势,在生后1~7 d,早产B组PI值均显著低于早产A组(P<0.05或P<0.01);在生后1~2 d,早产A组PI值均显著低于足月A组(P<0.01),在生后3~7 d,2组PI值比较差异无统计学意义(P>0.05);足月B组和早产B组生后1~7 d PI值比较差异均无统计学意义(P>0.05)。结论动态监测PI值对发现新生儿病情变化有指导作用,生后早期PI值受胎龄影响,胎龄越小PI越低。Objective To investigate the change and significance of early perfusion index(PI)in critically ill neonates.Methods A total of 106 neonates were divided into full-term group(gestational age>37 weeks,51 cases)and preterm group(gestational age≤37 weeks,55 cases).According to the neonatal critical illness score(NCIS),these neonates were further divided into full-term A group(stable condition,30 cases),full-term B group(critical condition,21 cases),preterm A group(stable condition,34 cases),and preterm B group(critical condition,21 cases).The PI was recorded 1-7 days after birth using a MasimoRadical-7 SpO2 monitor(USA),and the data were compared within and between groups.Results The PI increased gradually from 1 to 7 days after birth in both full-term and preterm groups.Furthermore,the PI in full-term B group was lower than that in full-term A group 1-4 days after birth,and that in preterm B group was lower than that in preterm A group 1-7 days after birth(P<0.05 or P<0.01).There was no significant difference in the PI between full-term A group and full-term B group 5-7 days after birth(P>0.05).In addition,the PI in preterm A group was lower than that in full-term A group 1-2 days after birth(P<0.01).However,the difference was not significant between preterm A group and full-term A group 3-7 days after birth,as well as between preterm B group and full-term B group 1-7 days after birth(P>0.05).Conclusion Dynamic PI monitoring plays a guiding role in finding the change of neonatal condition.The PI is affected by gestational age in early postnatal period.The younger the gestational age,the lower the PI.

关 键 词：危重新生儿 生后早期 血流灌注指数 新生儿危重病评分 

分 类 号：R320.34[医药卫生—人体解剖和组织胚胎学]