振幅整合脑电图在新生儿窒息早期诊断和预后评估中的临床价值

摘要

Objective To investigate the clinical value of amplitude integrated electroencephalogram on early diagnosis and prognosis evaluation of brain injury caused by neonatal asphyxia.Methods A total of 34 full-term asphyxiated neonates(asphyxia group)hospitalized in NICU of our hospital from January 2015 to September 2015 were selected;meanwhile,34 full-term healthy infants(control group)of the same term were selected.All cases were monitored for the activities of aEEG background,sleep-awakening cycle(SWC)and epileptic activity(SA)within 6 hours after birth.Meanwhile,the relationships between various indexes and asphyxia degree and brain injury were analyzed.Results The electroencephalogram of the asphyxia group was 52.9％and the rate of SWC was 58.8％,which were lower than those of the control group,and the difference had statistic significance(P<0.05).Meanwhile,neonates with epileptic activity in asphyxia group accounted for 11.8％,which was higher than that of control group significantly(P<0.05).Conclusion The AEEG changes of neonates at early period after birth are closely related to perinatal asphyxia and brain injury after asphyxia.The application of amplitude integrated electroencephalogram has an important significance on early diagnosis of neonatal asphyxia.%目的 探讨振幅整合脑电图(aEEG)对新生儿窒息导致脑损伤的早期诊断及预后评估的临床价值.方法 选择2015年1-9月在该院新生儿重症监护病房住院的34例足月分娩窒息新生儿(窒息组)及同期34例健康足月儿(对照组),均于生后6 h内开始监测aEEG背景活动、睡眠-觉醒周期(SWC)、痫性活动(SA)的特点,并分析各指标与窒息程度、脑损伤的关系.结果 窒息组新生儿脑电图呈连续者占52.9％,SWC成熟率为58.8％,均低于对照组,比较差异有统计学意义(P<0.05);窒息组发生痫性活动的新生儿占11.8％,明显高于对照组,比较差异有统计学意义(P<0.05).结论 新生儿出生后早期aEEG变化与围产期窒息及窒息后脑损伤密切相关,采用aEEG对出生时具有脑损伤高危因素的窒息足月新生儿提供早期诊断、早期干预的理论依据.