摘要
目的评价振幅整合脑电图(a EEG)在新生儿缺氧缺血性脑病(HIE)早期诊治及预测预后中的应用价值。方法选择2015年1月到2016年11月治的60例HIE新生儿(胎龄37~41周)作为研究对象,另选择同时期的50例非颅脑病症足月儿作为对照组。两组均行a EEG,观察两组的脑电图连续性和睡眠-觉醒周期(SWC),分析a EEG结果与HIE的相关性,按a EEG分类,将所有患儿分为轻度、中度、重度3个分度,均随访6个月,评价a EEG对患儿预后的预测价值。结果观察组的脑电图连续性和成熟型SWC所占比率均显著低于对照组(P<0.05);观察组最高电压高于对照组,最低电压低于对照组,差异均有统计学意义(P<0.05);随访6个月,不同分度HIE患儿智能发育筛查(DST)评分均明显低于对照组,差异具有统计学意义(P<0.05),重度HIE患儿的癫痫发作率显著高于对照组和轻度、中度HIE组(P<0.05);经相关性分析,a EEG结果与HIE临床分度呈显著正相关(r=0.782,P<0.05)。结论a EEG分类对HIE患儿预后评估具有极好的预见性,尤其是重度异常a EEG患儿,其临床预后极差;a EEG检查无创伤、操作简便,且能够连续监测,具有很高的临床应用价值。
Objective To evaluate the value of the amplitude integration of eeg （aEEG） in the early diagnosis and treatment and predict prognosis of neonatal hypoxic ischemic encephalopathy （ HIE）. Methods From January 2015 to November 2015 in our hospital, 60 cases of HIE newborns （37 ~41 weeks gestational age） were selected as the research objects, 50 cases of cerebral disease full term in the same period as control group. aEEG were performed in the two groups. EEG continuity and sleep - wake cycle （SWC） were observed, and the correlation of aEEG re-sults with HIE were analyzed. The children were divided into mild, moderate, severe degree classified by aEEG, and were followed up for 6 months. The prognosis of children predicted by aEEG were evaluated. Results EEG continuity and mature SWC proportion in observation group were significantly lower than that of the control group （ P 〈0. 0 5 ） . The highest voltage in observation group was higher than that of the control group , the minimum voltage was lower than that of the control group, the differences were statistically significant （ P 〈 0. 0 5 ） . When followed up for 6 months, different degree HIE children intelligence developmental screening （DST） score were significantly lower than those of the control group, the difference was statistically significant （ P 〈0. 0 5 ） . Severe HIE children with epileptic seizure rate was significantly higher than that of the control group and mild and moderate HIE group （ P 〈0. 0 5 ） . Through correlation analysis, aEEG results with HIE clinical index was signifi-cantly positively related （ r =0.782,P 〈0.05）. Conclusion aEEG classification to evaluate prognosis of children with HIE has great foresight, especially for children with severe abnormal aEEG, the clinical prognosis is poor. aEEG examination is noninvasive, easy to operate, and able to perform continuous monitoring. Therefore, it is of great value in clinical application.
出处
《临床和实验医学杂志》
2017年第12期1227-1230,共4页
Journal of Clinical and Experimental Medicine
关键词
新生儿
缺氧缺血性脑病
振幅整合脑电图
诊断
预后评估
智能发育评价
Newborn
Hypoxia ischemic encephalopathy
Amplitude integration of electroencephalogram
Diagnosis
Prognostic evalua-tion
Intelligent development evaluation
