多导定量分析振幅整合脑电图在脑损伤儿童的临床应用

Clinical Application of Multi-Channel Quantitative Amplitude-Integrated Electroencephalography in Children with Brain Injury

【目的】探讨脑损伤儿童振幅整合脑电图(a EEG)改变以及与神经系统早期预后的关系。【方法】采用16导联的a EEG监测模式对100例脑损伤患儿(脑损伤组)及100例正常儿童(对照组)进行监测。对两组儿童不同年龄段额、中央、顶、颞区的波谱进行比较,比较脑损伤组儿童急性期及1周后a EEG特点,分析脑损伤儿童的a EEG特点。同时随访记录3个月后脑损伤组儿童脑功能等级评分(PCPC),并评价脑损伤儿童a EEG的变化与PCPC评分的相关性。【结果】2-12月正常婴儿与异常婴儿下边界电压相比额区、颞区明显增高(P<0.05);带宽的比较,额区、中央区、颞区脑损伤婴儿较正常婴儿明显降低(P<0.05)。13-35月的脑损伤儿童与正常对照组a EEG比较表明:所有导联的上边界及下边界电压均较正常组明显增高(P<0.05)。36-71月脑损伤儿童与正常儿童下边界电压相比额区、中央区、顶区、颞区明显增高(P<0.05);上边界的比较中仅额区、顶区差异具有统计学意义(P<0.05)。72-155月脑损伤儿童与正常儿童下边界电压相比额区、中央区、顶区、颞区明显增高(P<0.05);上边界的比较中仅额区、中央区、顶区差异具有统计学意义(P<0.05);带宽比较额区、顶区两组间比较差异有统计学意义(P<0.05)。156-216月脑损伤儿童与正常儿童下边界电压相比额区、中央区、顶区、颞区明显增高(P<0.05);上边界的比较中额区、中央区、顶区、颞区明显增高(P<0.05);带宽比较仅额区两组间比较差异有统计学意义(P<0.05)。脑损伤患儿3个月后的PCPC评分与患儿a EEG进行相关分析表明顶区上边界、下边界存在相关性,相关系数分别为0.222,0.219。【结论】脑损伤儿童的各导联下边界电压发生改变,脑损伤患儿早期顶区a EEG定量值可用于预测患儿的近期预后。

【Objective】To study the change of amplitude-integrated electroencephalography(a EEG)and the relationship with neurological prognosis in children with brain injury.【Methods】This study included 100 brain injured children,100 normal children as the control group. Quantitative a EEG in frontal,temporal,parietal and central lobe were compared. The a EEG in brain injured children were reexamined after 1 week. The follow-up was observed after 3 months and pediatric cerebral performance category score(PCPC)was recorded for each patient.【Results】The 2-12 months group frontal and temporal lower margin amplitude were significantly increased,P<0.05,bandwidth in frontal,temporal and central channels were significantly decreased,P<0.05. In 13-35 months group all lower and upper margin amplitudes were significantly higher in brain injury group than normal control group,P<0.05. In 36-71 months group,frontal,temporal,parietal and central lower margin amplitude were significantly increased,P<0.05.However,only upper margin amplitude in frontal and parietal lobe were significantly different,P<0.05. In 72-155 months group,the lower margin amplitude of frontal,central,parietal and temporal channels were significantly increased,P<0.05;the upper margin amplitude of frontal,central,parietal channels were significantly different,P<0.05;the bandwidth were significantly different in frontal and parietal channels,P<0.05. In 156-216 months group,the lower and upper margin amplitude of frontal,central,parietal and temporal channels were significantly increased,P<0.05;the bandwidth were significantly different in frontal channel,P<0.05.Correlation analysis shows that the PCPC after 3 months was significantly correlated to upper and lower voltage of parietal channels,r=0.222,0.219,respectively.【Conclusion】The lower margin amplitude in brain injured children were changed,and the early a EEG of parietal channel have predict value for early prognosis.