脑电图监测在新生儿低血糖脑损伤诊断及预后中的应用研究  

The applicative study of EEG monitoring in diagnosing and prognosis of the neonates with hypoglycemic brain damage

作　　者：梁志明[1] 尤金英[1] 梁辰宇 张彤[1] 李建国[1] 吴发宗[1] 

机构地区：[1]江西省吉安市妇幼保健院儿童保健科,吉安343000 [2]赣南医学院基础医学院,赣州341000

出　　处：《江西医药》2014年第12期1352-1356,共5页Jiangxi Medical Journal

基　　金：江西省科技支撑计划(2012 2BBG 70142)

摘　　要：目的研究新生儿低血糖脑损伤(HBD)时脑电图(EEG)的变化特点及与颅脑磁共振MRI检查结果间的关系,探寻EEG在预测HBD及预后中的应用价值。方法选取52例低血糖性新生儿,分为症状性低血糖组25例,无症状性低血糖组27例,分析比较两组患儿在血糖值、持续时间、EEG检查及与MRI检查结果间差别和关联。结果两组患儿在入院时血糖值比较(t=9.69,P<0.001)、低血糖持续时间比较(t’=2.06,P<0.05)、EEG监测异常率比较(首次χ2=10.7,P<0.005;再次χ2=26.61,P<0.005)、MRI检查异常率比较(χ2=28.66,P<0.005)均有统计学差异;症状性低血糖组的EEG检查与MRI检查结果间存在关联(Fisher精确概率P=0.000113<0.05),两种检查异常检出率相同(χ2=0,P>0.05);在无症状性低血糖组,两种检查结果不存在关联(Fisher精确概率P=0.074>0.05);两组内及两组间EEG及MRI检查结果异常的差异,其患儿临床预后也不尽相同。结论结合血糖值及临床症状体征,EEG监测在新生儿低血糖脑损伤的诊断及预后方面有其特征意义的变化,可用来早期动态监测HBD、评估预后。Objective To study the relationship between the change characteristics of EEG and MRI examination results in neonates with hypoglycemic brain damage （HBD）,and to explore the application value of prediction as well as clinical prognosis in neonates with HBD. Methods Fifty-two neonates diagnosed with hypoglycaemia were selected,and divided into two groups：symptomatic hypoglycemic group（n=25） and asymptomatic hypoglycemic group（n=27）. Analysis and compare the differences and relevance in blood glucose levels,duration,EEG and MRI results. Results There was statistical differences in the blood glucose of the two groups neonates （t=9.69,P〈0.001）,the hypoglycemic duration （t’=2.06,P〈0.05）,the abnormal rate of EEG monitor （firstχ2=10.7,P〈0.005;againχ2=26.61,P〈0.005） and the abnormal rate of MRI examination （χ2=28.66,P〈0.005）. There is relevance be-tween the EEG and the MRI results of symptomatic hypoglycemic group,the abnormal rates of these examinations are the same（χ2=0,P〉0.05）. And there was irrelevance between the EEG and the MRI results of asymptomatic hypoglycemic group （Fisher exact probability P=0.074〉0.05）. There were differences in or between the abnormal of two groups as well as the clinical prognosis of the neonates with hypoglycaemia. Conclusion Combined with the blood glucose level and clinical symptoms and signs,EEG have sig-nificant changes in diagnosing hypoglycemic brain damage and can be used for monitoring dynamically hypoglycemic brain dam-age early and evaluate prognosis.

关 键 词：新生儿 低血糖 脑损伤 脑电图监测 

分 类 号：R722.1[医药卫生—儿科]