Schmidt S, Decleer W, Gorissen-Bosselmann S, Pringle K, Helledie N, Rolfe P, Krebs D
Universitäts-Frauenklinik, Bonn.
Z Geburtshilfe Perinatol. 1990 Sep-Oct;194(5):219-23.
In order to evaluate the influence on the fetal brain due to compression of the umbilical cord biochemical and biophysical changes were traced during defined occlusions of 60 sec by means of NIR laser spectroscopy. Synchronously blood samples were drawn intermittently from a catheter positioned in the A. carotis and analysed for blood gases. The saturation values measured in the fetal blood correlated significantly with the dates of the HbO2 tracing of the NIR-system (r = 0.81, p less than 0.001). After induced occlusion of the umbilical cord a reproducible pattern of the NIR tracing occurred. While an immediate fall in HbO2 occurred, a synchronous rise in desaturated Hb was observed. For the changes of the cytochrome aa3 we detected a minor decrease that occurred with a lag time. Additionally there was an indication of a major change of blood volume as the total Hb content augmented during each compression. We concluded: Changes of Hb-saturation in the fetal blood are immediately indicated by NIR-laser spectroscopy. During cord occlusion of 60 sec. the intracellular oxygenation decrease only after a significant lag time and are reversible and furthermore it leads to a reproducible change of intracerebral blood volume.
为了评估脐带受压对胎儿大脑的影响，借助近红外激光光谱法在60秒的特定闭塞期间追踪生化和生物物理变化。同时，从置于颈动脉的导管间歇性抽取血样并分析血气。胎儿血液中测得的饱和度值与近红外系统的HbO2追踪数据显著相关（r = 0.81，p < 0.001）。脐带诱导闭塞后，近红外追踪出现了可重复的模式。虽然HbO2立即下降，但观察到去饱和Hb同步上升。对于细胞色素aa3的变化，我们检测到有轻微下降且有滞后时间。此外，有迹象表明血容量有重大变化，因为每次压迫期间总Hb含量增加。我们得出结论：近红外激光光谱法可立即显示胎儿血液中Hb饱和度的变化。在脐带闭塞60秒期间，细胞内氧合仅在显著滞后时间后下降且是可逆的，并且还导致脑内血容量发生可重复的变化。
