aEEG与VEEG在儿童重症监护病房昏迷患儿中的应用价值  

The value of amplitude integrated-electroencephalography and video electroencephalogram in coma children in intensive care unit

作　　者：肖曙芳[1] 翟娜娜 孙伟伟[2] 董芳玲 李斌[1] XIAO Shufang;ZHAI Nana;SUN Weiwei;DONG Fangling;LI Bin(Pediatric Intensive Care Unit,the Children′s Hospital of Kunming City,Kunming,Yunnan 650000,China;Electroencephalogram Chamber,the Children′s Hospital of Kunming City,Kunming,Yunnan 650000,China)

机构地区：[1]昆明市儿童医院儿童重症监护病房,云南昆明650000 [2]昆明市儿童医院脑电图室,云南昆明650000

出　　处：《检验医学与临床》2019年第10期1343-1347,共5页Laboratory Medicine and Clinic

基　　金：云南省昆明市科技计划项目(2016-2-S-06663)

摘　　要：目的探讨昏迷患儿早期振幅整合脑电图(aEEG)与多导联视频脑电图(VEEG)的变化,指导对预后的判断。方法选择2016年8月至2018年2月入住昆明市儿童医院儿童重症监护病房、存在不同程度意识障碍的患儿共80例为研究对象,根据格拉斯哥昏迷评分法分为轻、中、重度昏迷。在发病72h内采用Nicolet one monitor脑电监护仪描记aEEG同时记录原始VEEG,将aEEG结果分为正常、轻度异常和重度异常,将VEEG结果分为正常、轻度异常、中度异常、重度异常VEEG波形,运用统计学方法进行统计。结果 aEEG分度与昏迷分度、VEEG分度存在显著的正相关(r=0.881、0.840,P<0.05),昏迷分度与预后存在相关(r=0.280,P<0.05),aEEG分度、VEEG分度与预后存在中强度相关(r=0.529、0.569,P<0.05)。aEEG异常对昏迷患儿不良预后早期评估的灵敏度为72.5%,特异度为70.0%,阳性预测值为70.7%,阴性预测值为71.8%。aEEG重度异常对昏迷患儿不良预后早期评估的灵敏度为57.5%,特异度为95.0%,阳性预测值为92.0%,阴性预测值为69.0%。结论 aEEG与昏迷分度具有良好的相关性,其中重度异常aEEG能够早期预测昏迷患儿的不良预后。Objective To observe the changes of early amplitude-integrated electroencephalogram (aEEG) and video electroencephalogram (VEEG) in coma children and to guide the judgment of prognosis. Methods A total of 80 children with different level of consciousness disorder who were hospitalized in pediatric intensive care unit of Kunming Children′s Hospital from August 2016 to February 2018 were selected.According to the Glasgow Coma Scale,they were divided into light,moderate and severe coma.Within 72 hours after the onset of the disease,the children′s aEEG and the original VEEG were recorded with a Nicolet one monitor.The aEEG results were divided into normal aEEG,mild abnormal aEEG and severe abnormal aEEG waveform.The VEEG results were divided into normal,mild abnormal,moderate abnormal and severely abnormal VEEG waveform.The results were analyzed systematically. Results There was significant positive correlation between aEEG,coma indexing and VEEG ( r =0.881,0.840, P <0.05),there was significant correlation between coma and prognosis ( r =0.280, P <0.05),there was intensity correlation between aEEG,VEEG and prognosis ( r =0.529,0.569, P <0.05).The sensitivity of abnormal aEEG in early assessment of poor prognosis in coma children was 72.5%,specificity was 70.0 %,positive predictive value was 70.7%,and negative predictive value was 71.8%.The severity of aEEG severe abnormalities in early assessment of poor prognosis in coma children was 57.5%,the specificity was 95.0%,the positive predictive value was 92.0%,and the negative predictive value was 69.0%. Conclusion The aEEG has excellent correlation with coma indexing,especially severe aEEG could predict the poor prognosis of coma children early.

关 键 词：振幅整合脑电图 视频脑电图 昏迷 儿童 预后 

分 类 号：R444[医药卫生—诊断学]