AEEG联合床边头颅B超对新生儿窒息脑损伤的早期诊断价值  

Early Diagnostic Value of AEEG 0x09Combined with Bedside Cranial Ultrasound in Neonatal Asphyxial Brain Injury

作　　者：郑莉 黄恺 余珊珊 ZHENG Li;HUANG Kai;YU Shanshan(Neonatology Department,Fuding Hospital,Fuding City,Fujian Province 355200;不详)

机构地区：[1]福建省福鼎市医院新生儿科,355200 [2]福建省福鼎市医院儿科,355200 [3]福建省福鼎市医院超声科,355200

出　　处：《医学理论与实践》2024年第5期738-740,728,共4页The Journal of Medical Theory and Practice

摘　　要：目的:研究振幅整合脑电图(AEEG)联合床边头颅B超对新生儿窒息脑损伤的早期诊断价值。方法:选取2022年1月—2023年6月在我院新生儿病房治疗的窒息新生儿90例作为窒息组,另选取同期健康新生儿40例作为健康组,两组均行AEEG及床边头颅B超检查。对比两组AEEG检查背景活动、睡眠—觉醒周期(SWC)及癫痫活动(SA)情况,头颅B超大脑动脉血管收缩峰流速(Vs)、平均峰流速(Vm)、舒张峰流速(Vd)及阻力指数(RI)指标值,对比AEEG及床边头颅B超单独及联合检测对新生儿窒息性脑损伤的诊断结果与金标准的一致性,分析各检测方式的诊断效能。结果:(1)窒息组患儿背景模式异常率、SWC异常率及SA发生率均高于健康组,差异有统计学意义(P<0.05);(2)床边头颅B超显示,出生24h,窒息组Vs、Vm、Vd指标值高于健康组,RI低于健康组,差异有统计学意义(P<0.05),出生72h,窒息组Vs、Vm、RI指标值高于健康组,Vd低于健康组,差异有统计学意义(P<0.05);(3)AEEG联合床边头颅B超检测结果与金标准具有较好一致性(Kappa=0.768),优于AEEG与头颅B超单独检测(AEEG Kappa=0.649,头颅B超Kappa=0.579);(4)AEEG联合床边头颅B超检测对新生儿窒息性脑损伤诊断灵敏度、特异度、准确度、阳性预测值及阴性预测值均高于AEEG或头颅B超单独检测,差异有统计学意义(P<0.05)。结论:窒息新生儿在AEEG及床边头颅B超检查结果中会有明显异常,联合检测对新生儿窒息性脑损伤的诊断效能良好,具有参考价值。Objective:To study the early diagnostic value of amplitude integrated Electroencephalography(AEEG)combined with bedside cranial ultrasound in neonatal asphyxia brain injury.Methods:90 asphyxiated neonates who were treated in the neonatal ward of our hospital from January 2022 to June 2023 were selected as the asphyxia group,and 40 healthy neonates in the same period were selected as the healthy group.AEEG and bedside head ultrasound were performed in both groups.The background activity,sleep-wake cycle(SWC)and epileptic activity(SA)of the two groups were compared,and the peak contractile flow rate(Vs),average peak flow rate(Vm),peak relaxation flow rate(Vd)and resistance index(RI)index values of the cerebral arteries were compared,and the diagnostic results of AEEG and bedside head B-ultrasonography were compared with the gold standard,and the diagnostic efficacy of each method was analyzed.Results:(1)The incidence of background pattern abnormalities,SWC abnormalities,and SA in the asphyxia group was higher than that in the healthy group,with statistically significant differences(P<0.05).(2)Bedside cranial ultrasound showed that at 24 hours of birth,the values of Vs,Vm,and Vd indicators in the asphyxia group were higher than those in the healthy group,while RI was lower than that in the healthy group,with a statistically significant difference(P<0.05).At 72 hours of birth,the values of Vs,Vm,and RI indicators in the asphyxia group were higher than those in the healthy group,while Vd was lower than that in the healthy group,with a statistically significant difference(P<0.05).(3)The results of AEEG combined with bedside head B-ultrasound were in good agreement with the gold standard(Kappa=0.768),and better than those of AEEG or head B-ultrasound alone(AEEG Kappa=0.649,head B-ultrasound Kappa=0.579).(4)The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of AEEG combined with bedside cranial ultrasound for the diagnosis of neonatal asphyxial brain injury were higher than those

关 键 词：振幅整合脑电图 床边头颅B超 新生儿窒息 诊断效能 

分 类 号：R444[医药卫生—诊断学] R445.1[医药卫生—临床医学] R722.1