视频脑电图在新生儿缺氧缺血性脑病诊断和预后评估中的价值  

The diagnostic and short-term prognostic value of video electroencephalogram in neonate with hypoxic-ischemic encephalopathy

作　　者：吴华平[1] 钟建民[1] 谢基华[1] 虞雄鹰[1] 陈勇[1] 何玲[1] 王启新[1] 王倩[1] 

机构地区：[1]江西省儿童医院,南昌330006

出　　处：《江西医药》2014年第1期6-9,共4页Jiangxi Medical Journal

基　　金：江西省卫生厅科技计划课题(20071140)

摘　　要：目的探讨视频脑电图在新生儿缺氧缺血性脑病诊断和短期预后评估中的作用。方法采用视频脑电图对HIE新生儿进行监测,应用NBNA评分、Gesell发育商测定对HIE患儿进行预后评估。结果 (1)出生后48h内VEEG异常率为85.7%(36/42),治疗后死亡4例,日龄2周时VEEG异常率为68.4%(26/38)。生后48h内及日龄2周内VEEG与临床分度相关。(2)不同分度HIE患儿早期NBNA评分差异有统计学意义。重度HIE患儿NBNA评分明显低于轻中度HIE。不同临床分度与NBNA评分存在相关性。(3)VEEG重度异常HIE患儿6个月龄随访发育商明显低,HIE患儿早期NBNA评分与6个月龄Gesell总发育商高度相关。结论 VEEG是判断HIE损害程度和预后的重要指标,早期VEEG与NBNA评分对HIE短期预后的评估具有一致性。Objective To evaluate the diagnostic and short-term prognostic value of video electroencephalogram （VEEG） in neonate with hypoxic-ischemic encephalopathy （HIE）. Methods VEEG were recorded in 42 neonates with HIE from Jiangxi chil-dren＆#39;s hospitals within 48h of births and 2 weeks after births. NBNA scoring was performed within the first 12h hospital admission and Gesell development quotient were performed at six months of age. Results （1） VEEG were normal in 6 cases and in 36 were abnormal at 48h after births in 42 patients,there were 4 cases died within the first week. 26 （68.4%） cases out of the 38 patients with HIE showed abnormal EEG. The degree of VEEG abnormality in neonates with HIE was consistent with the clinical grading of HIE. （2） The different clinical grading of HIE had different degree of early NBNA scores.Statistical significance was observed （P〈0.05）. The degree of NBNA scores with severe HIE were significantly lower than of the mild and moderate HIE. The degree of NBNA scoring in neonates with HIE was consistent with the clinical grading of HIE. （3）We followed up the other patient at 6 months of age. The degree of Gesell developmental quotient with severe HIE were significantly lower than of the mild and moder-ate HIE. The degree of NBNA scoring in neonates with HIE was consistent with the clinical grading of HIE. Conclusion VEEG is the important indicators for the extent of brain damage and the prognosis of neonatal HIE. VEEG and early NBNA scoring have the consistency for the evaluation of short-term prognosis of HIE.

关 键 词：缺氧缺血性脑病 视频脑电图 NBNA评分 发育商 预后 

分 类 号：R722.12[医药卫生—儿科]