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极低出生体重早产儿体位变化对脑和肠系膜组织氧合的影响。

Cerebral and mesenteric tissue oxygenation by positional changes in very low birth weight premature infants.

机构信息

Division of Neonatology Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey.

出版信息

Early Hum Dev. 2012 Jun;88(6):409-11. doi: 10.1016/j.earlhumdev.2011.10.005. Epub 2011 Nov 15.

Abstract

AIM

There has been no clear consensus of the appropriate positioning in preterm infants. We aimed to evaluate the changes of cerebral and mesenteric tissue oxygenation in three different positions, by near infrared spectroscopy (NIRS), in stable very low birth weight (VLBW) infants of postnatal >30 days.

METHODS

NIRS monitoring of cerebral and mesenteric tissue oxygenation in three different positions was performed in 29 stable preterm newborns in neonatal intensive care unit (NICU). The patients were observed in three different positions consecutively, each lasting for 4h. The demographic features, cerebral and mesenteric tissue oxygenation with positional changes and feeding periods were recorded.

RESULTS

Mean gestational age, mean birth weight and mean postnatal age of the patients were 27.6±1.7 weeks, 1046±308 g and 42.4±15.7 days, respectively. There were no statistically significant differences in cerebral and mesenteric tissue regional SO(2) values in each position (p=0.954 and p=0.151, respectively). The values of cerebral and mesenteric tissue regional SO(2) before and after feeding did not show any statistically significant difference in each position.

CONCLUSIONS

Clinically stable very low birth weight infants are able to maintain a stable cerebral and mesenteric tissue oxygenation in different positions, both before and after feeding. Positional changes seem to be safe in VLBW stable infants and this influence should be considered in care of these patients in the NICU. Clinical Trials Identification Number: NCT01255189.

摘要

目的

早产儿的适宜体位尚未达成明确共识。我们旨在通过近红外光谱(NIRS)评估出生后>30 天的稳定极低出生体重(VLBW)婴儿在三种不同体位下脑和肠系膜组织氧合的变化。

方法

对新生儿重症监护病房(NICU)中 29 例稳定的早产儿进行了三种不同体位的脑和肠系膜组织氧合 NIRS 监测。连续观察患儿在三种不同体位下的情况,每个体位持续 4 小时。记录患儿的人口统计学特征、体位变化时的脑和肠系膜组织氧合以及喂养周期。

结果

患儿的平均胎龄、平均出生体重和平均出生后年龄分别为 27.6±1.7 周、1046±308g 和 42.4±15.7 天。三种体位下脑和肠系膜组织区域 SO₂ 值无统计学差异(p=0.954 和 p=0.151)。三种体位下喂养前后脑和肠系膜组织区域 SO₂ 值均无统计学差异。

结论

临床稳定的极低出生体重儿能够在不同体位下保持稳定的脑和肠系膜组织氧合,且无论在喂养前后。体位变化似乎对 VLBW 稳定婴儿是安全的,这一影响应在 NICU 中对这些患者的护理中加以考虑。临床试验注册号:NCT01255189。

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