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目的探讨振幅整合脑电图(a EEG)在窒息新生儿脑损伤早期诊断的应用价值,为指导临床治疗和早期干预提供依据。方法选择2014年1月~2015年12月在潍坊市妇幼保健院NICU住院的50例窒息新生儿作为研究对象,依据病情对全部患儿进行临床分度,分为轻度窒息及重度窒息。对50例窒息新生儿均进行动态a EEG监测,记录出生后6h,3d,7d新生儿振幅整合脑电图(a EEG)检查结果;所有窒息新生儿生后第3d行头颅MRI检查。分析窒息新生儿生后6h内不同程度的a EEG结果与窒息新生儿临床分度的相关性,以及与MRI检查结果的一致性。结果 (1)50例窒息新生儿中,a EEG正常者为13例(26.0%),a EEG轻度异常者为21例(42.0%),a EEG重度异常者为16例(32.0%);轻度窒息新生儿13例(59.1%)a EEG检查结果正常,8例(36.4%)a EEG检查结果轻度异常,1例(4.5%)a EEG检查结果重度异常;重度窒息新生儿13例(46.4%)a EEG检查结果轻度异常,15例(53.6%)a EEG检查结果重度异常。相关性分析结果显示r=0.699,P<0.001。(2)窒息新生儿6h内a EEG正常者为13例(26.0%),a EEG异常者为37例(74.0%),头颅MRI检查结果显示,正常者为20例(40.0%),异常者30例(60.0%)。Kappa等级相关性分析示Kappa值=0.437,P<0.001,差异有统计学意义。结论 6h内a EEG监测结果与窒息临床分度有很好的相关性,6h内a EEG监测结果显示重度异常者窒息程度越重。a EEG监测窒息新生儿脑损伤与头颅MRI监测结果一致性较高。
Objective To investigate the value of amplitude-integrated electroencephalography (aEGG) in early diagnosis of asphyxial neonatal brain injury and provide evidence for clinical treatment and early intervention. Methods From January 2014 to December 2015, 50 neonates with asphyxia who were hospitalized in NICU of Weifang Maternal and Child Health Hospital were enrolled in this study. All children were divided into mild asphyxia and severe asphyxia according to their clinical condition. A total of 50 neonates with asphyxia were monitored by dynamic EEG, and the results of amplitude integrated EEG were recorded at 6h, 3d and 7d after birth. All neonates with asphyxia were examined by cranial MRI on the third day after birth. To analyze the correlation between the degree of a EEG and the clinical index of neonates with asphyxia within 6h after asphyxia neonatorum, and the consistency with MRI examination results. Results (1) Among 50 asphyxiated newborns, 13 cases (26.0%) had a normal EEG, 21 cases (42.0%) had a mild EEG, and 16 cases (32.0%) had a severe EEG. EEG examination results were normal in 13 cases (59.1%) of mild asphyxia, mild abnormalities of EEG in 8 cases (36.4%) and severe abnormalities of EEG in 1 case (4.5%). Thirteen cases of severe neonatal asphyxia (46.4%) aEEG test results mild abnormalities, 15 cases (53.6%) aEEG test results severe abnormalities. Correlation analysis showed r = 0.699, P <0.001. (2) Thirteen cases (26.0%) of normal neonates with asphyxia and 37 cases of abnormal EEG (74.0%) were diagnosed as neonatal asphyxia in 6 hours. The results of cranial MRI showed that 20 cases (40.0%) were normal, 30 cases (60.0%). Kappa rank correlation analysis showed Kappa value = 0.437, P <0.001, the difference was statistically significant. Conclusion The results of a-EEG monitoring within 6 hours have a good correlation with the clinical index of asphyxia. The results of a-EEG monitoring within 6 hours show that the more severe the degree of asphyxia is, the heavier the degree of asphyxia is. a EEG monitoring asphyxial neonatal brain injury and head MRI monitoring results are consistent.