振幅整合脑电图在新生儿缺氧缺血性脑病早期诊治及预测预后中的应用价值  

Application value of the amplitude integrated electroencephalography in early diagnosis and treatment of hypoxic-ischemic encephalopathy and predict prognosis

作　　者：魏巍[1] 商明霞[1] 韩涛[1] 韩笑[1] 柴妍楠 尹晓娟[1] 

机构地区：[1]北京军区总医院附属八一儿童医院足月新生儿重症监护病房,北京100700

出　　处：《中国儿童保健杂志》2014年第4期361-364,共4页Chinese Journal of Child Health Care

基　　金：中国博士后基金(20070410505)

摘　　要：目的评估振幅整合脑电图（aEEG）在缺氧缺血性脑病（hypoxic-ischemic encephalopathy,HIE）早期诊治及远期预后中的应用价值。方法选择2010年8月-2013年2月在八一儿童医院NICU住院的120例HIE患儿作为研究对象,胎龄34-42＋2周,随机分为aEEG观测组及非观测组,每组60例。两组再根据HIE严重程度分为轻度、中度、重度3个亚组,每亚组20例。分别在生后第1、3、14及28天等时相点对aEEG观测组HIE患儿进行aEEG监测;在第3、14、28天对各组HIE患儿进行新生儿神经行为测定（NBNA）评分;对出院患者在矫正胎龄12月时进行随访,内容包括丹佛发育筛查量表（DDST）及预后评估。结果 aEEG与HIE临床分度存在显著正相关（r=0.843,P〈0.01）。在第3天和第14天时相点zEEG观测组与非观测组NBNA评分无统计学意义（P〉0.05）,而在第28天时相点,aEEG观测组与非观测组NBNA评分有统计学意义（P〈0.05）。在第1、3、14及28天时相点,观测组aEEG与矫正胎龄满12月时预后均存在强正相关（r=0.832、0.857、0.778、0.743,P〈0.01）。aEEG观测组致残率（13.8%）显著低于非观测组（23.2%）;aEEG观测组痊愈率（60%）显著高于非观测组（40%）;aEEG观测组和;非观测组远期预后有统计学意义（χ2=4.107,P〈0.05）。结论 aEEG与HIE临床分度具有极好的相关性,可以早期协助诊治HIE;aEEG可以用于预测HIE远期预后。Objective To evaluate the application value of the aEEG in early diagnosis and treatment of hypoxic-ische mic encephalopathy （HIE） and long-term prognosis. Methods A total of 120 eases of newborns with HIE who were hospitalized from August 2010 to February 2013 were selected,and their gestational ages were from 34-42^＋2 weeks. 120 cases of newborns were randomly dividing into the observation group with aEEG and non-observation group. According to the severity of HIE,each group was divided into mild,moderate,and severe subgroup,each subgroup with 20 cases, aEEG was respectively traced at time points（1,3,14 and 28 days） after birth for observation group with aEEG;Two groups of HIE took the Neonatal Behaviral Neuro/ogieal Assessment （NBNA） assessment at time points（3,14 and 28 days） after birth; follow up research for two was done groups after corrected gestational age of 12 months,the follow-up investigation including Denver Developmental Screening Test （DDST） and nervous system sequelae. Results There was positive correlation between aEEG and HIE clinical indexing （r= 0. 843,P〈0.01）. At time points（3 and 14 days）after birth,it was not statistically significant for the NBNA score between observation group with aEEG and non-observation group （P〉0.05）while it was statistically significant for the NBNA score between observation group with aEEG- and non-observation group at time point 28 day after birth（P〈0.05）. At time points （1,3,14 and 28 days）after birth, the aEEG results for observation group with aEEG had strong positive correlations with prognosis after corrected gestational age of 12 months（r=0. 832,0. 857,0. 778, 0. 743,P〈0.01）. The disable rate in the observation group with aEEG （13.8%） was significantly lower than that in the non-observation group （23.2%）; the cure rate （60%） in the observation group with aEEG was significantly higher than that in the non-observation group （40 % ）. The long-term prognosis of the observation group with aEEG

关 键 词：振幅整合脑电图 新生儿缺氧缺血性脑病 早期诊断 

分 类 号：R722.1[医药卫生—儿科]