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目的:探讨振幅整合脑电图(aEEG)对窒息新生儿脑损伤的早期诊断价值及与近期神经行为的相关性研究。方法:采用前瞻性研究方法,对2010年3~9月本院收治的中、重度窒息新生儿,记录生后6 h内、5天、10天aEEG,生后3天内行头颅MRI检查。分析生后6 h内不同表现的aEEG、不同程度MRI与相应程度窒息新生儿的敏感性和特异性。生后5天、10天不同程度aEEG与窒息新生儿近期神经系统预后的相关性。2月龄时门诊随访小儿52项神经运动检查,6月龄时门诊随访小儿神经心理发育检查。结果:分析50例窒息新生儿。其中轻、重度窒息分别为23和27例。生后6 h内aEEG,异常37例,异常率74%。轻重度异常率分别为42%和32%。50例新生儿MRI,异常30例(60%)。2月龄行神经行为学评估,神经行为异常18例,其6 h内aEEG均为异常。6月龄行儿童神经心理发育测试正常有44例、偏低4例、低下2例。结论:生后6 h内aEEG对窒息新生儿早期脑损伤有较好的诊断价值,与新生儿近期神经系统发育的相关性较好。
Objective: To investigate the early diagnostic value of amplitude-integrated electroencephalography (aEEG) in neonatal asphyxia brain damage and its correlation with recent neurobehavioral. Methods: A prospective study was conducted to evaluate the incidence of aEEG in 6 h, 5 d and 10 d after birth in children with moderate or severe asphyxia admitted in our hospital from March to September in 2010, and cranial MRI was performed within 3 days after birth. The sensitivity and specificity of aEEG with different manifestations within 6 hours after birth and neonates with different degrees of MRI and corresponding degrees of asphyxia were analyzed. 5 days after birth, 10 days varying degrees of aEEG and neonatal asphyxia neonatorum prognosis of the recent correlation. At 2-month-old, 52 neurological examinations in children were followed up and neuropsychological tests in children were followed up at 6 months of age. Results: Fifty asphyxial newborns were analyzed. Among them, mild and severe asphyxia were 23 and 27 cases respectively. Within 6 h after birth, aEEG, abnormal in 37 cases, anomalous rate of 74%. The rates of severe and severe abnormalities were 42% and 32% respectively. 50 cases of newborn MRI, abnormal 30 cases (60%). 2-month-old neurobehavioral assessment, neurological abnormalities in 18 cases, within 6 h of aEEG are abnormal. In the 6-month-old children, there were 44 cases with normal neuropsychological test, 4 cases were low and 2 cases were low. Conclusion: Within 6 hours after birth, aEEG has a good diagnostic value for early brain injury in neonates with asphyxia, and correlates well with the recent development of nervous system in neonates.