多导长程录像脑电监测对新生儿高胆红素血症预后的评估价值  

Prognosis evaluated in hyperbilirubinemia of neonates with long term video-electroencephalography monitoring

作　　者：李磊[1] 李丽君[1] 孙伟伟[1] 黄秀华[1] 马小燕[1] 

机构地区：[1]昆明市儿童医院,云南昆明650228

出　　处：《中国儿童保健杂志》2016年第5期555-558,共4页Chinese Journal of Child Health Care

基　　金：昆明市卫生科技人才培养项目暨"千"工程后备人选培养计划[sw(后备)-69]

摘　　要：目的运用多导长程脑电图对足月高胆红素血症新生儿进行监测,研究足月新生儿高胆红素血症的脑电图,分析其对预后判断的价值。方法选取足月新生儿（受孕龄为37~42周）,其中42例无高胆红素血症的非神经系统疾病患儿和98例高胆红素血症患儿进行多导长程录像脑电监测,每个患儿于出生后第一周内进行脑电监测,并于出生后15天,出生后第一个月末,出生后第三个月分别进行3次随访,分别进行脑电图检查及生长发育评估。采用多样本比较秩和检验和多样本率的比较对血清总胆红素、脑电图结果以及后遗症发生率进行分析。结果 1）不同血清总胆红素水平等级的患者,其脑电图结果有显著差异;脑电图异常率同血清总胆红素水平的增高程度有一定关系。特别是正常组总胆红素水平与中、重度增高组,轻、中度增高组与重度增高组间脑电图结果差异显著。2）脑电图的结果对判断胆红素血症预后有一定意义,且随着脑电图异常程度的增加,预后愈加不容乐观,特别是重度异常脑电图的高胆红素血症患儿,其后遗症发生率明显高于脑电图正常和轻度异常者。结论新生儿多导长程录像脑电监测结合血清总胆红素水平不仅可反映高胆红素血症患儿脑功能的受损程度,还可作为早期预后判断的一个重要手段,该方法简单、方便、经济,可作为新生儿高胆红素血症所致脑损伤的严重程度和预后评估的常规检查方法之一。Objective To investigate the combination between the electroencephalography（EEG） and the hyperbilirubi- nemia of full-term newborn by the long term video-electroencephalography （VEEG） monitoring,and to evaluate the clinical value of the long term （VEEG） monitoring in the prognosis judgment of hyperbilirubinemia of full term newborn. Methods EEG was studied for 42 full-term newborns without hyperbilirubinemia and nervous system disease,and 98 full-term new- borns with hyperbilirubinemia in the first week. And they were assessed for EEG and neurological development three times （postnatal 15 days, 1 and 3 months）. A statistical method of rank-sum test was adapted in investigate relationship of EEG, serum bilirubin and prognosis judgment. Results 1） There were significant differences in EEG results among the serum bilirubin level. The abnormal rate of EEG was related to the increase of serum bilirubin level. Especially EEG results had significant differences of serum bilirubin level among the normal,moderate and severe groups, and between the mild, moderate and severe group. 2）The EEG results were valuable to hyperbilirubinemia prognosis iudgment, and with increase of the degree of EEG abnormality, the prognosis was not optimistic, especially the neonates of severe abnormal EEG with hyperbiliru binemia and the incidence of sequelae was significantly higher than that of EEG results in both normal and mild abnormal neonates. Conclusions The long term video-electroencephalography monitoring is combined with serum bilirubin level,it is not only reflect the extent of the damage of hyperbilirubinemia brain function,but also as the early prognosis judgment of an important method. The method is simple,convenient and economic. One of the routine method can be used as the severity of brain injury induced by neonatal hyperbilirubinemia and prognosis.

关 键 词：脑电图 新生儿 高胆红素血症 预后 

分 类 号：R179[医药卫生—妇幼卫生保健]