应用近红外光成像技术检测不同疲劳程度医务人员逻辑运算任务期间前额叶皮质血氧反应变化  

Application of near-infrared spectroscopy in detecting changes of blood oxygen reaction in prefrontal cortex of medical staff with different fatigue levels during logical operation task

作　　者：蒋童 陈晓菲[1] 齐秦甲子 张林[2] 曹子敬 吴斯佳 王钰静 侯艳红[1] JIANG Tong;CHEN Xiaofei;QI Qinjiazi;ZHANG Lin;CAO Zijing;WU Sijia;WANG Yujing;HOU Yanhong(Department of Medical Psychology,the Eighth Medical Center,Chinese PLA General Hospital,Beijing 100091,China;Senior Department of Gastroenterology,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Unit 61672 Clinic of PLA,Beijing 100010,China)

机构地区：[1]解放军总医院第八医学中心医学心理科,北京100091 [2]解放军总医院第一医学中心消化内科医学部,北京100853 [3]解放军61672部队门诊部,北京100010

出　　处：《解放军医学院学报》2021年第11期1148-1152,1162,共6页Academic Journal of Chinese PLA Medical School

基　　金：军委后勤保障部卫生局基金(BWS16J012)。

摘　　要：背景既往研究发现监测和评估医务人员脑疲劳状态对工作任务中持续保持良好工作绩效具有重大意义,但目前针对医务人员脑疲劳状态的评估和研究缺乏生理性指标。近红外光成像技术(near-infrared spectroscopy,NIRS)作为一种无创、便携且操作简单的脑功能成像技术,可实时监测前额叶区血氧饱和度,可能为识别和评估脑疲劳状态提供依据。目的应用NIRS检测不同疲劳程度医务人员逻辑运算任务期间前额叶皮质血氧反应变化。方法 2016年2-3月随机抽取某医院74名医务工作者,其中男性22例(29.73%),女性52例(70.27%),年龄19~40(28.97±1.82)岁。应用视觉模拟评分法按主观疲劳度分为轻、中、重度3组,完成逻辑运算任务的同时进行NIRS检测,比较3组间额叶区域氧合血红蛋白(oxyhemoglobin,oxy-Hb)和还原血红蛋白(deoxyhemoglobin,Deoxy-Hb)的差异。结果在无任务期间,不同疲劳状态分组各个通道的oxyHb含量和Deoxy-Hb含量组间差异均无统计学意义(P>0.05)。逻辑运算任务期间oxy-Hb含量:中度疲劳组CH14、CH15、CH16通道oxy-Hb含量较重度疲劳组明显上升(P<0.05);轻度疲劳组CH13通道oxy-Hb含量较中度疲劳组明显下降(P<0.05)。逻辑运算任务期间Deoxy-Hb含量:轻度疲劳组CH4通道Deoxy-Hb含量较中度疲劳组明显下降,轻度疲劳组CH9、CH12、CH13、CH15、CH16通道Deoxy-Hb含量较重度疲劳组明显下降(P<0.05)。结论 NIRS可以检测逻辑运算任务下额叶激活状态。不同疲劳状态下处理复杂任务,脑血氧含量差异有统计学意义(P<0.05),部分脑区脑血氧含量下降,而部分脑区脑血氧含量上升,表明受试者脑活动增强,出现机体代偿机制。Background Previous studies have found that exploring and evaluating the mental fatigue state on medical staff is of great significance to improve productivity in the workplace. However, the physiological markers for exploring and evaluating the mental fatigue state on medical staff have not yet been identified. As a non-invasive, portable and simple brain functional imaging technology, near-infrared spectroscopy(NIRS) can monitor the blood oxygen reaction in prefrontal lobe in real time, which may provide evidences for identifying and evaluating the mental fatigue state. Objective To detect the variation of blood oxygen reaction in the prefrontal cortex of medical staff under different fatigue levels based on logical operation tasks by near-infrared spectroscopy.Methods From February to March in 2016, 74 medical workers were randomly selected from a hospital, including 22 males(29.73%) and 52 females(70.27%), aged from 19 to 40(28.97±1.82) years. The participants were divided into mild, moderate, and severe groups by the visual simulation score method according to the subjective fatigue degree. The near-infrared spectroscopy was used to detect the transition of oxyhemoglobin and deoxyhemoglobin in the frontal lobe region while completing the logical operation task, and the differences in oxidized hemoglobin and deoxyhemoglobin in frontal lobe of patients in the three groups were compared. Results During baseline, there were no statistically significant differences in oxy-Hb content and Deoxy-Hb content at any channel(P<0.05). In different fatigue states, oxy-Hb content was compared during logic operation task. Compared with severe fatigue, the oxy-Hb content decreased significantly in CH14, CH15 and CH16 channels during moderate fatigue(P<0.05), and it increased significantly in CH13 during mild fatigue when compared with moderate fatigue(P<0.05, respectively). The Deoxy-Hb content in CH4 channel decreased significantly during mild fatigue when compared with moderate fatigue, and in CH9, CH12,CH13, CH15 and CH1

关 键 词：脑疲劳 近红外光成像技术 逻辑运算 氧合血红蛋白 还原血红蛋白 

分 类 号：R749.99[医药卫生—神经病学与精神病学]