摘要
目的探讨持续脑功能监测在新生儿脑损伤早期诊断及预后评价的应用价值。方法选取我院2011年1月至2014年1月收治中、重度窒息新生儿50例,记录出生后6 h、24 h、48 h新生儿振幅整合脑电图(a EEG)以及出生后3 d内头颅MRI检查结果。比较不同时间段内a EEG预测窒息患儿早期脑损伤的特异性与敏感性,并比较两种检查方式对窒息患儿脑损伤诊断的一致性。2月龄时及6月龄时分别进行神经行为学评估以及小儿神经心理发育检查。结果 50例窒息新生儿中,中度窒息23例,重度窒息27例。出生后6 h内a EEG显示,异常37例(74.0%),其中轻、重度异常率分别为42.0%、32.0%。MRI检查显示,异常30例(60.0%),正常20例(40.0%)。2月龄时进行神经行为学评估,神经行为异常18例(36.0%)。6月龄时进行儿童神经心理发育测试,正常44例(88.0%),偏低4例(8.0%),低下2例(4.0%)。结论新生儿出生后6 h内a EGG对窒息新生儿早期脑损伤有着较好的临床诊断价值,与新生儿近期神经系统发育的相关性较大。
Objective To investigate the application value of continuous cerebral function monitoring in early diagnosis and prognostic evaluation of newborns with cerebral injury. Methods 50 cases of neonates with moderate/severe asphyxia treated in our hospital from January 2011 to January 2014 were selected. The a EEG of newborns in 6 h, 24 h, 48 h and head MRI in 3 d were recorded. The specificity and sensitivity of a EEG in predicting early cerebral injury of neonates with asphyxia at different stages were compared, and the consistency of two inspecting methods in diagnosing cerebral injury of neonates with asphyxia were also compared. Neonates in two months and six months were given neurobehavioral evaluation and neuropsychological development respectively. Results In 50 cases of neonates with asphyxia, 23 cases had moderate asphyxia and 27 cases had severe asphyxia. The a EEG of newborns in 6 h showed abnormality in 37cases（74.0%）, with the light abnormality rate was 42.0% and severe abnormality rate was 32.0%. The MRI showed abnormality in 30 cases（60.0%） and normality in 20 cases（40.0%）. The result of neurobehavioral evaluation showed abnormality in 18 cases（36.0%）, the result of neuropsychological development showed normality in 44 cases（88.0%）, moderate abnormality in 4 cases（8.0%） and abnormality in 2 cases（4.0%）. Conclusions The a EEG of newborns in 6 h has better clinical value in diagnosis of early cerebral injury of neonates with asphyxia,which has great correlation with the development of recent nerve system of newborns.
出处
《临床医学工程》
2015年第6期677-678,共2页
Clinical Medicine & Engineering
基金
东莞市科技计划项目(项目编号:201410515)
关键词
新生儿
脑损伤
预后
脑功能监测
Newborn
Cerebral Injury
Prognosis
Cerebral function monitoring
