aEEG对新生儿缺氧缺血性脑病远期神经行为的预测作用研究

Predictive eff ect of a EEG on long-term neuro-behaviour about neonates with hypoxic-ischemic encephalopathy

目的探讨aEEG对新生儿缺氧缺血性脑病患儿远期的神经行为预测。方法通过前瞻性研究,收集40例HIE新生儿,收集其aEEG情况,并于1岁左右再次随访患儿的神经行为发育情况。结果共收集40例HIE新生儿,1岁后随访病人共35例,5例未能回院随访及电话随访。HIE的严重程度与aEEG的背景及睡眠周期相关。轻度HIE患儿中连续正常电压比例高,中度HIE中不连续正常电压比例高,重度HIE中爆发抑制及连续低电压比例高,三者有明显的统计学差异(χ~2=13.7498,P<0.001)。轻度HIE患儿中成熟SWC比例高,中度HIE中不成熟SWC比例高,重度HIE中无SWC比例高,三者有明显的统计学差异(χ~2=22.773,P<0.000)。aEEG的背景中,连续正常电压、不连续正常电压及爆发抑制的患儿的Gesell的五个能区的得分差异有统计学意义(P<0.05)。aEEG的睡眠周期中,成熟SWC、不成熟SWC及无SWC患儿的Gesell的五个能区的得分有差异有统计学意义(P<0.05)。结论 aEEG在脑功能的监测及远期的神经结局的预测有非常重要的作用。

Objective:To explore the long-term neurobehavioral prediction of neonates with hypoxic-ischemic encephalopathy by using the aEEG.Methods:By prospective study,40 HIE neonates were collected and their aEEG was collected.The neurobehavioral development of the neonates was followed up around 1 year old.Results:A total of 40 neonates with HIE were collected.35 cases were followed up after 1 year old.5 cases failed to return to hospital for follow-up and telephone follow-up.The severity of HIE is related to the background of aEEG and sleep-wake cycling.High correlation between mild HIE and continuous normal voltage,between mild HIE and disontinuous normal voltage,between severe HIE and burst suppression and continuous low voltage.They has significant statistical differences among the three groups(χ~2=13.7498,P<0.001).High correlation between mild HIE and mature SWC,between moderate HIE and immature SWC,between severe HIE and non-SWC,and they has significant statistical differences among the three groups(χ~2=22.773,P<0.000).About the background of aEEG,the scores of Gesell five regions in children with continuous normal voltage,discontinuous normal voltage and burst suppression were significantly different(P<0.05).About the sleep cycle of aEEG,the scores of Gesell five regions in children with mature SWC,immature SWC and non-SWC were significantly different(P<0.05).Conclusion:aEEG plays an important role in monitoring brain function and predicting long-term neurological outcomes.