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目的 探讨新生儿高胆红素血症患儿脑损伤的早期预测方法。 方法 对 38例高胆患儿分别进行新生儿神经行为评分 (NBNA)和脑干听觉诱发电位 (BAEP)检测。 结果 高胆组BAEP异常率明显高于对照组 (P <0 0 1) ,Ⅰ、Ⅴ波潜伏期与对照组比较差异显著 (P <0 0 1,P <0 0 5 )。高胆组NBNA评分明显低于对照组 (P <0 0 0 1) ,主要失分项目为行为能力和主动肌张力。在血清胆红素≥ 2 0 4μmol/L时 ,胆红素水平与NBNA评分呈显著负相关 (P <0 0 1) ,血清胆红素浓度≤ 2 5 6 5 μmol/L时 ,部分高胆患儿NBNA评分即有降低 ,BAEP异常率增高 ,黄疸消退后NBNA评分全部恢复正常。 结论 NBNA和BAEP是早期诊断新生儿胆红素脑病敏感而有效的方法 ,有助于判断病情及指导治疗。
Objective To investigate the early prediction of brain injury in neonates with hyperbilirubinemia. Methods Thirty-eight children with hyperbilirubinemia were respectively examined for neonatal neurobehavioral scores (NBNA) and brainstem auditory evoked potentials (BAEP). Results The abnormal BAEP rate was significantly higher in the control group than in the control group (P <0.01). The latency of Ⅰ and Ⅴ waves was significantly different from that in the control group (P <0.01, P <0.05). NBNA score in the group of high gallbladder was significantly lower than that of the control group (P <0.01). The main item of losing score was behavior ability and active muscle tone. There was a significant negative correlation between the level of bilirubin and the NBNA score (P <0.01) when serum bilirubin was ≥ 204 μmol / L, and partly elevated when serum bilirubin concentration was ≤ 2565 μmol / L Children with NBNA score decreased, BAEP abnormal rate increased, NBNA score jaundice subsided all returned to normal. Conclusion NBNA and BAEP are sensitive and effective methods for the early diagnosis of neonatal bilirubin encephalopathy, which is helpful to judge the condition and guide the treatment.