aEEG联合头颅MRI对极低出生体重儿早期颅内出血的评估

AEEG combined with cranial MRI assessment of early cerebral hemorrhage in VLBW

目的探讨a EEG联合头颅MRI对极低出生体重儿早期颅内出血诊断的临床意义。方法将64例极低出生体重儿依据PVH-IVH诊断结果分为PVH-IVH组(n=34)和非PVH-IVH组(n=30),所有患儿在生后6h内、第3天、第7天均采用脑功能监护仪CFM6000描记患儿振幅整合脑电图,根据a EEG轨迹将结果分为正常波形、轻度异常波形和重度异常波形。研究对象生后4~14d给予苯巴比妥钠镇静行头颅MRI检查,根据检查结果分为正常组、轻度出血组(Ⅰ级及Ⅱ级)、重度出血组(Ⅲ级及Ⅳ级)。结果对比PVH-IVH组和非PVH-IVH组a EEG的异常率,统计分析显示差异明显(P<0.05)。生后6h内、第3天、第7天的两组a EEG异常率相比,统计分析均有明显差异(P<0.05)。随着患儿日龄的增加,a EEG的异常率逐渐降低,但对比生后第7天异常率,PVH-IVH组比非PVH-IVH组高,统计学分析上有差异(P<0.05)。a EEG异常程度与MRI分度有显著相关性(spearman等级相关系数0.762,P<0.001)。结论 a EEG可联合头颅MRI对极低出生体重儿颅内出血程度进行早期评价,且生后日龄与a EEG异常程度呈负相关。

Objective To explore the clinical significance of a EEG combined with cranial MRI in early diagnosis of intracranial hemorrhage in very low birth weight infants. Methods Sixty-four cases of very low birth weight infants based on PVH-IVH diagnosis were divided into PVH-IVH Group and non-PVH-IVH Group,the amplitude integrated EEG was recorded by CFM6000 within 6 hours,3 days and 7 days after birth,according to the a EEG trajectory,the results can be divided into normal waveform,mild abnormal waveform and severe abnormal waveform. All objects were applied with head MRI examination in sodium phenobarbital calm after birth 4 - 14 d. According to the examination results,they were divided into normal group,mild hemorrhage group,and severe hemorrhage group. Results The abnormal rate of a EEG in PVH-IVH group and non-PVH-IVH group was compared,statistical analysis showed significant differences（ P〈0. 05）. With the age growing of children,abnormal rate of a EEG gradually reduced. PVH-IVH group was higher than non-PVH-IVH group for abnormal rate in after7 d birth. It had differences in statistical analysis（ P〈0. 05）. Abnormal a EEG and MRI had significant correlation（ Spearman rank correlation coefficient is 0. 762,P〈0. 001）. Conclusion AEEG combined with cranial MRI can be a good method for early evaluation of intracranial hemorrhage in very low birth weight infants,and age is negatively correlated with a EEG abnormal degree days.