近红外光谱技术在神经外科患者脑氧和血流动力学监测中的应用研究进展

神经外科患者,尤其是脑血流自动调节功能受损的重症患者,脑氧饱和度是反应患者脑组织氧代谢情况的重要指标,实时、准确的脑氧饱和度监测方法对于指导选择有效的治疗措施和判断患者预后具有重要价值。基于血红蛋白不同氧合状态,即氧合血红蛋白(oxyhemoglobin,Hb O2),还原血红蛋白(deoxygenated hemoglobin,Hb)具有的差异性分子光谱,近红外光谱技术near infrared spectroscopy,NIRS)可监测人体局部组织氧饱和度。由于近红外射线能穿透颅骨直接获得脑组织内平均氧饱和度的特性,可协助临床实现无创持续监测脑氧饱和度的目的,近年来该技术在神经外科领域的应用研究获得了迅速发展,在颅脑创伤和其它神经外科疾病的应用研究中均取得了显著的进展,本文将对最新研究结果及其意义和未来发展方向进行综述。

Research and Progress of the Application of Near Infrared Spectroscopy inthe Detection on the Cerebral Oxygen and Haemodynamics ofNeurosurgical Patients

A real-time and accurate method of detecting cerebral oxygen saturation of neurosurgical patients, especially criticalpatients with damaged autoregulation of cerebral blood flow, has important value in guiding the selection of effective treatment measuresand judging patient outcomes, for cerebral oxygen saturation is an important indicator that reflects the oxygen metabolism of the braintissues in such patients. Based on the different oxygenations of the hemoglobin - oxyhemoglobin (HbO2), and the differentiated molecularspectrum of deoxygenated hemoglobin (Hb), the near infrared spectroscopy (NIRS) can detect oxygen saturation of local tissues. It ishelpful to realize the objective of noninvasive continuous detection on cerebral oxygen saturation, because near infrared radial candirectly penetrate the skull to obtain the characteristics of the average oxygen saturation of the brain tissues. In recent years, the researchon the application of this technology in neurosurgery has developed rapidly and significant progress has been made in the research on theapplication of this technology in traumatic brain injury and other neurosurgical diseases. For this reason, this paper will summarize thelatest research results and their meanings as well as the future development trend related to this technology.