目的:探讨肾氧饱和度(RrSOn 2)和腹部局部氧饱和度(A-rSOn 2)在婴幼儿心脏手术中的变化规律和临床应用价值。n 方法:随机连续选取2019年4-8月河南省人民医院儿童心脏中心体外循环(CPB)下行房间隔缺损和/或室间隔缺损修补的患儿30例，男15例，女15例，年龄2～13个月，体质量4.5～10.0 kg，美国麻醉医师协会(ASA)分级Ⅰ～Ⅲ级。应用近红外线分光仪的探头分别固定于患儿右肾体表定位处和肚脐下方1 cm，术中持续监测患儿RrSOn 2和A-rSOn 2。分别记录麻醉诱导后(Tn 0)，体外循环开始即刻(Tn 1)，阻断升主动脉后5 min(Tn 2)，体温最低时(Tn 3)，开放升主动脉后5 min(Tn 4)，停机后5 min(Tn 5)的RrSOn 2、A-rSOn 2、平均动脉压(MAP)、鼻咽温等参数的变化。记录术中CPB时间、升主动脉阻断时间、手术时间等相关情况。记录围术期(术后)急性肾损伤(AKI)、胃肠道功能障碍等并发症发生情况。记录术后首次开始进食时间等相关情况。n 结果:本研究共纳入30例患儿，患儿RrSOn 2和A-rSOn 2基础值分别为(70.00±7.50)%、(70.70±11.29)%。与Tn 0比较，患儿RrSOn 2和A-rSOn 2在Tn 1时下降，在Tn 2、Tn 3、Tn 4时逐渐升高，在Tn 5时恢复至Tn 0水平。患儿RrSOn 2和A-rSOn 2在Tn 0、Tn 1、Tn 2、Tn 3、Tn 4差异无统计学意义。n Pearson相关分析显示患儿A-rSOn 2与RrSOn 2呈正相关(n r＝0.806，n P<0.01)，RrSOn 2和A-rSOn 2均与MAP呈正相关(n r＝0.565、0.605，均n P<0.05)，与鼻咽温均呈负相关(n r＝-0.365、-0.331，均n P<0.05)。其中，术后发生AKI患儿3例，AKI总体发生率10%(3/30例)。与Tn 0比较，患儿RrSOn 2值在Tn 1、Tn 2、Tn 3、Tn 4时明显降低(n P<0.05)。术后发生胃肠功能滞后患儿6例，胃肠功能滞后总体发生率20%(6/30例)。胃肠功能滞后患儿A-rSOn 2值在Tn 0～Tn 5明显低于未发生胃功能滞后患儿(n P<0.05)。n 结论:作为一种新型无创监测手段，近红外线光谱技术在婴幼儿简单先天性心脏病修补术围术期肾功能和肠道功能的监测方面具有一定的临床指导价值。“,”Objective:To investigate the changes and their clinical values of renal oxygen saturation(RrSOn 2) and abdominal local oxygen saturation(A-rSOn 2) in infants who underwent cardiac surgery.n Methods:Thirty children with atrial septal defect or ventricular septal defect underwent cardiopulmonary bypass (CPB) in Henan People′s Hospital from April to August 2019 were randomly selected.There were 15 males and 15 females, aged 2-13 months, weighted 4.5-10.0 kg and American Society of Anesthesiologists(ASA) grade Ⅰ-Ⅲ.The probe of near-infrared spectroscopy(NIRS)was fixed at the body surface of the right kidney and 1 cm below the umbilicus.RrSOn 2 and A-rSOn 2 were continuously monitored during operation.The changes of parameters, including RrSOn 2, A-rSOn 2, mean arte-rial pressure(MAP), and nose temperature were recorded after anesthesia induction (Tn 0), cardiopulmonary bypass (Tn 1), 5 minutes after aortic blockade (Tn 2), the lowest temperature (Tn 3), 5 minutes after aortic opening (Tn 4), and 5 minutes after stopping cardiopulmonary bypass (Tn 5). CPB time, ascending aorta occlusion time and operation time were recorded as well.Meanwhile, perioperative complications such as acute renal injury (AKI) and gastrointestinal dysfunction were recorded.Relevant information, including the time of first eating after operation was recorded.n Results:Totally, 30 children were enrolled in this study.The basic values of RrSOn 2 and A-rSOn 2 were (70.00±7.50)% and (70.70±11.29)%, respectively.Compared with Tn 0, the RrSOn 2 and A-rSOn 2 of patients decreased at Tn 1, gradually increased at Tn 2, Tn 3 and Tn 4, and returned to Tn 0 at Tn 5.There was no significant difference in RrSOn 2 and A-rSOn 2 at each observation point.n Pearson correlation analysis displayed that there was a positive correlation between A-rSOn 2 and RrSOn 2 (n r=0.806, n P<0.01). RrSOn 2 and A-rSOn 2 were positively correlated with MAP (n r=0.565, 0.605, all n P<0.05), and negatively correlated with the nasopharynx temperature (n r=-0.365, -0.331; all n P<0.05). Among them, 3 children(10%) suffered from AKI after operation.Compared with Tn 0, RrSOn 2 values at Tn 1, Tn 2, Tn 3 and Tn 4 decreased significantly (n P<0.05). Postoperative gastrointestinal hysteresis occurred in 6 children(20%). The A-rSOn 2 value in Tn 0-Tn 5 of children with gastrointestinal hysteresis was significantly lower than that of children without gastrointestinal hysteresis (n P<0.05).n Conclusions:As a new noninvasive monitoring method of renal and intestinal function, NIRS has certain clinical guiding value in perioperative period of infantile congenital heart disease.