新生儿住院患者振幅整合脑电图监测结果分析  

Analysis of amplitude-integrated electroencephalogram monitoring in hospitalized neonates

作　　者：秦胜娟[1] 张丽 刘敬[1] 高月乔 邱如新 刘燕妮 郭九叶[1] 卢祖琳 Qin Shengjuan;Zhang Li;Liu Jing;Gao Yueqiao;Qiu Ruxin;Liu Yanni;Guo Jiuye;Lu Zulin(Department of Neonatology,Chaoyang District Maternal and Child Health Hospital,Beijing 100021,China)

机构地区：[1]北京市朝阳区妇幼保健院新生儿科,100021

出　　处：《中华全科医师杂志》2021年第8期858-862,共5页Chinese Journal of General Practitioners

摘　　要：目的分析新生儿病房开展振幅整合脑电图(aEEG)检查的结果。方法纳入2017年9月至2019年8月在北京市朝阳区妇幼保健院新生儿科住院并接受aEEG检查的患儿,分析不同疾病新生儿患者aEEG异常发生率,aEEG异常表现形式,以及aEEG异常与临床异常情况的一致性。结果本研究1370例患儿中,aEEG异常308例,异常率22.5%。危重患儿异常率27.7%(240/868),非危重患儿异常率为13.6%(68/502),差异有统计学意义(χ^(2)=36.3,P<0.01)。不同疾病aEEG的异常率前5名依次为惊厥57.1%(16/28)、小于胎龄儿48.8%(20/41)、窒息41.5%(49/118)、早产儿31.1%(92/296)、红细胞增多症29.7%(11/37)。aEEG异常的类型主要有背景活动异常229例(74.4%)、睡眠觉醒周期不明显139例(45.1%)和原始脑电异常117例(40.0%)。在308例aEEG异常患儿中,有异常临床表现者117例,占38.0%;无明显异常临床表现者191例,占62.0%。aEEG监测敏感性73.6%(117/159),特异性为84.2%(1020/1211)。结论住院新生儿尤其危重患儿aEEG异常率较高,且多数无相应临床表现,存在明显的临床-脑电分离现象,提示对住院新生儿患者常规实施aEEG检查有利于早期发现脑损害。Objective To analized brain function monitoring results with amplitude-integrated electroencephalogram(aEEG)in neonatal ward.Methods The clinical data of 1370 newborns received aEEG monitoring in Neonatal Department of our hospital from September 2017 to August 2019 were retrospectively analyzed.Results Among 1370 neonates undergoing aEEG examination,abnormalities were demonstrated in 308 cases with an overall abnormal rate of 22.5%.The abnormal rate in critical neonates was 27.7%(240/868),while that in non-critical neonates was 13.6%(68/502)(χ^(2)=36.304,P<0.01).Neonates with convulsion had the highest aEEG abnormal rate(57.1%,16/28),followed by small for gestational age(SGA)(48.8%,20/41),asphyxia(41.5%,49/118),premature(31.1%,92/296)and erythrocytosis(29.7%,11/37).Among 308 cases of abnormal aEEG,the main types of abnormalities were abnormal background activity in 229 cases(74.4%),insignificant sleep-wake cycles in 139 cases(45.1%)and abnormal original EEG in 117 cases(40.0%).Among 308 cases of abnormal aEEG,38.0%(117 cases)had corresponding clinical manifestations and 62.0%(191 cases)had no clinical manifestations.The sensitivity of aEEG monitoring is 73.6%(117/159),and the specificity is 84.2%(1020/1211).Conclusions The abnormal rate of aEEG is high in hospitalized neonates,especially in critically ill neonates.It is necessary to carry out routine aEEG examination for hospitalized neonates in order to early detect brain function damage.

关 键 词：脑电描记术 新生儿 振幅整合脑电图 

分 类 号：R722.1[医药卫生—儿科]