| 摘要: |
| 目的:评估用于早产儿视网膜病变(ROP)检查的散瞳滴眼液滴眼前、期间及滴眼后早产儿脑氧合功能与脑血容量的变化。方法:前瞻性纳入2018 年1 月至2019 年6 月复旦大学附属儿科医院新生儿重症监护室(NICU)的52 例早产儿,共计完成60 次ROP 筛查。运用近红外光谱技术(NIRS)对散瞳滴眼液滴眼前30 min 至滴眼后30 min 的脑组织氧合指数(cTOI) 和脑组织血红蛋白指数(cTHI)进行监测。在研究过程中,利用监护仪同步记录动脉血氧饱和度( SpO2 )、心率( HR) 和平均动脉压(MAP)。同时,计算脑组织氧摄取分数(cFTOE)[cFTOE=(SpO2 -cTOI) / SpO2 ]。结果:纳入研究的早产儿胎龄为(29. 5±1. 6)周,出生体质量为(1 405±479) g。使用散瞳滴眼液后,cTOI 较基线水平有所下降,随后逐步恢复至检查起始前的基线水平( F =24. 60,P =0. 000 1)。cFTOE 先呈反向升高趋势,后缓慢回归至基线水平(F = 21. 10,P = 0. 000 3)。cTHI 则较基线水平有所下
降,而后趋于稳定(χ2 = 75. 00,P = 0. 000 2)。而用药前后SpO2 、HR 和MAP 水平比较差异无统计学意义( P = 0. 721、0. 615、0. 529)。结论:虽然散瞳滴眼液对SpO2 、HR 和MAP 无显著影响,但却改变了脑部氧合情况,如cTOI、cTHI 和cFTOE 的变化。这些发现为进一步研究散瞳滴眼液对脑血流动力学的影响提供了新的参考数据。 |
| 关键词: 早产儿 视网膜病变 散瞳滴眼液 近红外光谱技术 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2026.04.006 |
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| 基金项目: |
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| Effects of Mydriatic Eye Drops on Cerebral Oxygenation and Cerebral Blood Volume in Premature Infants with Retinopathy |
| Liu Lu1, Lu Chunmei2, Cheng Guoqiang2, Zhang Peng2 |
| (1. Shanghai Fifth People’s Hospital of Fudan University, Shanghai 201100, China; 2. Children’s Hospital of Fudan University, Shanghai 201102, China) |
| Abstract: |
| Objective: To evaluate changes in cerebral oxygenation and cerebral blood volume in premature infants before, during, and after the instillation of mydriatic eye drops for retinopathy of prematurity (ROP) screening. Method: A total of 52 premature infants who underwent 60 ROP screening exams were prospectively extracted in the neonatal intensive care unit (NICU) of the Children’s Hospital of Fudan University. Cerebral tissue oxygenation index (cTOI) and cerebral tissue hemoglobin index (cTHI) were continuously monitored by using near-infrared spectroscopy (NIRS) from 30 minutes before to 30 minutes after instillation of mydriatic eyedrops. The arterial oxygen saturation (SpO2 ), heart rate (HR) and mean arterial pressure (MAP) were simultaneously recorded throughout the study period. Additionally, cerebral fractional tissue oxygen extraction (cFTOE) was calculated as cFTOE = (SpO2 -cTOI) / SpO2 . Results: The mean gestational age of the included infants was (29. 5±1. 6) weeks, and the mean body mass was (1,405±479) g. Following instillation of mydriatic eye drops, cTOI showed a consistent decline and gradually returned to baseline levels before the start of the examination (F =24. 60, P =0. 000,1). In contrast, cFTOE initially increased and then slowly returned to baseline levels (F =21. 10, P =0. 000,3). Meanwhile, cTHI decreased consistently and then stabilized throughout the observation period (χ2 =75. 00, P =0. 000,2). No significant changes were observed in SpO2 , HR, and MAP before and after administration (P =0. 721, 0. 615, 0. 529). Conclusion: The mydriatic eye drops had no significant effect on SpO2 , HR, and MAP, but significantly altered the cerebral oxygenation status, such as the changes in cTOI, cTHI, and cFTOE. These findings provide reference data and establish a foundation for further research into the effects of mydriatic eys drops on cerebral hemodynamics. |
| Key words: premature infants retinopathy mydriatic eys drops near-infrared spectroscopy |
