摘要
目的探讨振幅整合脑电图(aEEG)在新生儿化脓性脑膜炎中的应用及与预后的关系。方法对35例化脓性脑膜炎患儿进行aEEG监测,记录aEEG背景活动图形、睡眠觉醒周期和痫样活动,并计算脑功能评分。6个月后进行小儿神经发育检查量表判断预后,分析aEEG指标与预后的相关性。结果 35例患儿中,正常aEEG 14例,轻度异常aEEG 10例,重度异常aEEG 11例,总异常检出率为60.00%;在aEEG背景活动图形中,连续正常电压16例,不连续正常电压12例,爆发-抑制5例,连续低电压或平台2例;共记录到单次痫性发作5例,反复痫性发作7例,癫痫持续状态3例;存在成熟睡眠觉醒周期13例,不成熟睡眠觉醒周期14例,无睡眠觉醒周期8例;脑功能评分<5分17例,5~8分10例,>8分8例。2例患儿死亡,33例患儿完成量表测定,不良预后发生率为37.14%(13/35)。不同aEEG背景活动图形、睡眠觉醒周期、痫样活动和脑功能评分的预后分布均有统计学差异(H=14.068、13.260、16.557和14.695,P<0.01);aEEG背景活动图形、睡眠觉醒周期、痫样活动和脑功能评分与预后均呈正相关(Kendall’s tau-b=0.593、0.541、0.681和0.612,P<0.01)。结论 aEEG可以作为新生儿化脓性脑膜炎早期脑功能监测的便捷工具,与患儿神经发育结局有一定相关性。
Objective To investigate the application of amplitude-integrated electroencephalography(aEEG)in neonatal purulent meningitis and its relationship with the prognosis.Methods Thirty-five newborns with purulent meningitis accepted aEEG monitoring.The background activity,sleep-wake cycle and seizure activity of aEEG were recorded,and the score of brain function was calculated.The prognosis of the newborns was estimated by children's neurodevelopment examination after 6 months,and the correlation between aEEG indexes and the prognosis was analyzed.by Kruskal-Wallis test and Kendall's tau-b correlation method.Results Of 35 newborns,the aEGG was normal in 14 cases,mildly abnormal in 10 cases,severely abnormal in 11 cases,and the total abnormal detection rate was 60.00%.For background activity of aEEG,16 cases had continuous normal voltage,12 cases had discontinuous normal voltage,5 cases had burstsuppression,and 2 cases had continuous low voltage or platform.The single seizure,recurrent seizure and status epilepticus were recorded in 5,7 and 3 cases,respectively.The sleep-wake cycle was mature in 13 cases,immature in 14 cases,and not seen in 8 cases.The score of brain function was less than 5 points in 17 cases,5-8 points in 10 cases,and more than 8 points in 8 cases.Two newborns died,and-the rest completed the children's neurodevelopment examination.The incidence of poor prognosis was.37.14%(13/35).There was statistical difference in the prognosis distribution of different background activity,sleep-wake cycle,seizure activity of aEEG,and score of brain function(H=14.068,13.260,16.557 and 14.695,P<0.01).Meanwhile,the background activity,sleep-wake cycle,seizure activity of aEEG and score of brain function were positively correlated with the prognosis(Kendall's tau-b=0.593,0.541,0.681 and 0.612,P<0.01).Conclusion The aEEG has a certain correlation with the neurodevelopment outcome,and could be used as a convenient tool for the early brain function monitoring in neonatal purulent meningitis.
作者
缪珀
孙斌
潘怡之
弓茹月
李洪
冯星
MIAO Po;SUN Bin;PAN Yizhi(Department of Neonatology,Affilated Children's Hospital,Soochow University,Suzhou 215025,CHINA)
出处
《江苏医药》
CAS
2021年第12期1211-1214,共4页
Jiangsu Medical Journal
基金
江苏省科技厅社会发展项目(BE2015644)。
关键词
振幅整合脑电图
化脓性脑膜炎
新生儿
Amplitude-integrated electroencephalography
Purulent meningitis
Newborn
