脑氧饱和度监测结合振幅整合脑电图对早产儿脑损伤神经行为发育的预测价值  

Predictive Value of Cerebral Oxygen Saturation Monitoring Combined with aEEG for Neurobehavioral Development of Premature Infants with Brain Injury

作　　者：刘晓静[1] 司志梅[1] 马欢欢 许晶晶 田鑫 LIU Xiaojing;SI Zhimei;MA Huanhuan;XU Jingjing;TIAN Xin(The First Department of Neonates,Baoding Maternal and Child Health Hospital,Baoding,Hebei 071000,China)

机构地区：[1]保定市妇幼保健院新一科,河北保定071000

出　　处：《临床误诊误治》2024年第21期55-61,共7页Clinical Misdiagnosis & Mistherapy

基　　金：2022年保定市科技计划自筹经费项目(2241ZF088)。

摘　　要：目的探讨脑氧饱和度(rSO_(2))监测结合振幅整合脑电图(aEEG)对早产儿脑损伤(BIPI)预测神经行为发育的临床意义,以利于早期采取相应措施,改善患儿预后。方法选取2022年2月至2023年2月收治的116例BIPI作为观察组,选择非BIPI作为对照组,均行aEEG、rSO_(2)检查。比较2组aEEG评分、rSO_(2),对比观察组不同胎龄、脑损伤程度、神经行为发育情况患儿aEEG评分、rSO_(2),分析aEEG总分、rSO_(2)与胎龄、神经行为发育、脑损伤程度的相关性,分析aEEG总分、rSO_(2)对BIPI神经行为发育异常的预测价值。结果观察组连续性、睡眠-觉醒周期、下边界振幅、带宽和下边界值及aEEG总分、rSO_(2)低于对照组(P<0.01);观察组不同胎龄、脑损伤程度、神经行为发育患儿连续性、睡眠-觉醒周期、下边界振幅、带宽和下边界值及aEEG总分、rSO_(2)比较差异有统计学意义(P<0.05,P<0.01);Spearman相关性分析显示,aEEG总分、rSO_(2)与胎龄呈正相关(r=0.654、0.678,P<0.01),与脑损伤程度、神经行为发育呈负相关(r=-0.642、-0.747,P<0.01;r=-0.687、-0.659,P<0.01)。aEEG评分、rSO_(2)单独及联合预测BIPI神经行为发育异常的曲线下面积分别为0.813、0.810、0.909,联合预测的曲线下面积大于单独预测。结论aEEG评分、rSO_(2)过低与BIPI胎龄、神经行为发育及脑损伤程度存在一定关联,联合检测aEEG评分、rSO_(2)可预测BIPI神经行为发育异常风险,指导临床早期采取干预措施,防止或减少后遗症发生。Objective To investigate the clinical significance of regional cerebral oxygen saturation(rSO 0x092)monitoring combined with amplitude-integrated electroencephalography(aEEG)in predicting neurobehavioral development of brain injury in premature infants(BIPI),so as to take corresponding measures early and improve the prognosis of pediatric patients.Methods In total,116 patients with BIPI treated from February 2022 to February 2023 were selected as observation group and non-BIPI as control group.aEEG and rSO_(2) examinations were performed.The aEEG score and rSO_(2) of the two groups were compared,and the aEEG score and rSO_(2) of the children with different gestational age,degree of brain injury and neurobehavioral development in the observation group were compared.The correlation between the total score of aEEG,rSO_(2) and gestational age,neurobehavioral development and degree of brain injury was analyzed,and the predictive value of the total score of aEEG and rSO_(2) on neurobehavioral development abnormalities of BIPI was analyzed.Results Continuity,sleep-wake cycle,lower boundary amplitude,bandwidth and lower boundary value,total score of aEEG and rSO_(2) in observation group were lower than those in control group(P<0.01).There were significant differences in gestational age,brain injury degree,continuity of neurobehavioral development,sleep-wake cycle,lower boundary amplitude,bandwidth and lower boundary value,total score of aEEG and rSO_(2) in the observation group(P<0.05,P<0.01).Spearman correlation analysis showed that the total aEEG score and rSO_(2) were positively correlated with gestational age(r=0.654,0.678,P<0.01),and negatively correlated with the degree of brain injury and neurobehavioral development(r=-0.642,-0.747,P<0.01;r=-0.687,-0.659,P<0.01).The area under the curve(AUC)of aEEG score,rSO_(2) alone and in combination for the prediction of neurobehavioral abnormalities in BIPI were 0.813,0.810 and 0.909,respectively.The AUC of combined prediction was significantly larger than that of single pred

关 键 词：脑氧饱和度 振幅整合脑电图 婴儿 早产 脑损伤 神经行为发育 胎龄 受试者工作特征 

分 类 号：R722[医药卫生—儿科]