振幅整合脑电图诊断新生儿脑损伤临床研究进展

Progress in Clinical Study of Amplitude Integrated Electroencephalography in Diagnosis of Neonatal Brain Injury

新生儿脑损伤(NBI)对新生儿生命和健康危害极大。有效防治NBI的前提在于加强新生儿脑发育状况的监测、及时诊断脑损伤及准确评估损伤程度。振幅整合脑电图(a EEG)作为一种简单化的脑电图监测方法,主要通过振幅高低、背景波形变化来判断睡眠情况,检测癫痫样波,并判断新生儿脑成熟度。与其他新生儿脑功能监测方法相比,a EEG具有仪器体积较小、操作方便、图形直观、分析判断难度小、受外界干扰少等优点,能及时、便捷、自动、连续、全面地记录脑电活动。临床实际中,a EEG主要用于诊断缺氧缺血性脑病和新生儿惊厥等脑损伤的病情,也用于辅助治疗,并能够从背景活动、阵发性活动和电持续状态三个方面评价新生儿缺氧缺血性脑病的预后状况。a EEG的不足在于对于短暂的惊厥活动依然难以全面描记,因此应用价值受限。a EEG的研究前提在于通过改进仪器功能和不断提高操作技能,扩大使用范围,尤其是在诊断癫痫、智力低下、中枢性运动障碍、视听障碍等脑损害方面提高准确度,增强实用价值。

Neonatal brain injury(NBI) is extremely harmful to the life and health of newborns.The premise of effective prevention and treatment of NBI is to strengthen the monitoring of neonatal brain development,timely diagnosis of brain injury,and assessment of the injury degree.Amplitude integrated electroencephalogram(a EEG),as a simplified method of EEG monitoring,mainly judges sleep status,detects epileptiform waves and judges neonatal brain maturity by amplitude and background waveform changes.Compared with other methods of neonatal brain function monitoring,a EEG has the advantages of small instrument volume,easy operation,intuitive graphics,less difficulty in analysis and judgment,less interference from the outside,and can record EEG activities in a timely,convenient,automatic,continuous and comprehensive manner.In clinical practice,a EEG is mainly used to diagnose brain damage such as hypoxic ischemic encephalopathy and neonatal seizures.It is also used for adjuvant therapy and can evaluate the prognosis of neonatal hypoxic-ischemic encephalopathy from three aspects: background activity,paroxysmal activity and electrical persistence.The shortcoming of a EEG is that it is still difficult to fully trace the short-term convulsions,so the application value is limited.The premise of a EEG research is to improve the function of the instrument and continuously improve the operation skills,and to expand the use scope,especially in the diagnosis of epilepsy,mental retardation,central dyskinesia,audio-visual disorders and other brain damage to improve the accuracy and practical value.