早期电生理改变对早产低体重儿临床指导意义

The clinical guiding significance of early electrophysiological changes in premature and low-birth-weight infants

目的通过对视频脑电图(VEEG)的原始脑电爆发-抑制电活动持续间隔时间的研究,探讨其与早产低体重儿脑室周围白质及早期脑功能变化的关系。方法对2013年8月~2014年6月本院新生儿重症监护室(NICU)收治100例早产低体重儿随机分成治疗组及对照组,治疗组自生后开始每周进行一次VEEG监测,直至生后4周或矫正胎龄32周为止,对治疗组VEEG结果异常的早产低体重儿采用早期营养脑神经及康复治疗,并随访跟踪两组婴儿生后3个月、6个月神经生长发育。结果治疗组早产低体重儿NBNA评分明显高于对照组(治疗组≥35的38例,对照组≥35的27例),差异有统计学意义;随访跟踪3个月,治疗组MDI、PDI>90例数明显多于对照组,x^2值分别为11.69和18.01,P值分别为0.008和0.005,差异均有统计学意义(P<0.05);6个月[治疗组MDI、PDI>90例数明显多于对照组,x^2值分别为6.46和7.99,P值分别为0.020和0.009,差异均有统计学意义(P<0.05)]神经生长发育情况明显优于对照组,差异有统计学意义。结论早产低体重儿早期进行脑功能动态监测有助于早期发现严重脑室周围白质损伤。

Objective To explore relationship between the duration interval time of explosive-suppression electrical activity on original EEG video and injury degree of the surrounding white matter and early brain function changes.Methods From August 2013 to June 2014 in our hospital,100 cases of premature and low-birth-weight infants in NICU were randomly divided into the treatment group and the control group.VEEG monitoring was implemented in the infants of the treatment group once a week until the 4th week after birth or 32 nd week（corrected gestational age）.The infants,whose VEEG results were abnormal in the treatment group,were treated with early rehabilitation treatment of cranial nerve and nutrition.The nerve growth and development of infants in both groups were followed up in the 3rd and 6th month.Results The NBNA score of premature and low-birth weight-infants in the treatment group was significantly higher than that in the control group[the treatment group（38 cases of more than 35） was better than 35 in the control group（27 cases of more than 35）].The nerve growth and development of the infants in the treatment group was significantly better than that of the infants in the control group,and the difference was statistically significant.[At 3months,the number of MDI and PDI in the treatment group was significantly higher than that in the control group,the x^2 was 11.69 and 18.01,the P was 0.008 and 0.005 respectively,the difference was statistically significant（P〈0.05）.At6 months,the number of MDI and PDI in the treatment group was significantly higher than that in the control group,the x^2 was 6.46 and 7.99,the P was 0.020 and 0.009 respectively,the difference was statistically significant（P〈0.05）].Conclusion Early cerebral function monitoring to premature and low-birth-weight infants is helpful for early discovery of severe injury of periventricular white matter.