摘要
目的探讨持续性数字脑电图监测(cEEG)对危重症所致继发性脑功能障碍患儿脑功能的评估意义。方法选取儿童重症监护病房(PICU)收治的继发性脑功能障碍患儿62例,收集患儿的一般临床资料(性别、年龄、发病年龄、临床表现、病因、有无癫痫持续状态及预后),神经中央监护系统进行cEEG监测,采用改良格拉斯哥昏迷量表(GCS)评分及参照synek分级标准评估患儿意识障碍的严重程度;出院后随访6个月患儿后遗症(语言发育落后、运动发育落后、语言运动发育落后及肌张力增高)的发生情况。结果继发性脑功能障碍患儿的病因以癫痫及颅内感染患儿多见,脑电图分级越高者改良GCS评分越低;弥漫性θ波背景、持续性弥漫性痫样放电或间断局灶性痫样放电,提示预后较差,可遗留部分后遗症;死亡组与存活组患儿性别、发病年龄、病因、cEEG痫样放电比较,差异无统计学意义(P>0.05)。结论cEEG可以早期发现危重症所致继发性脑功能障碍患儿的异常脑电图,通过连续性监测脑功能变化进一步评估脑损伤程度。
Objective To explore the significance of continuous digital EEG monitoring on brain prognosis in children with secondary brain dysfunction caused by critical illness.Method Sixty-two children with secondary brain dysfunction admitted to the pediatric intensive care unit(PICU)were selected.General clinical data of the children were collected(sex,age,age of onset,clinical presentation,etiology,presence of status epilepticus,and prognosis).The cEEG monitoring was performed and the severity of awareness impairment was assessed by the modified Glasgow Coma Scale(GCS)score and the synek grading criteria.The occurrence of sequelae of the children was followed up for 6 months after discharge(backward language development,backward motor development,backward language and motor development,and increased muscle tone).Result The etiology of children with secondary brain dysfunction was more common in children with epilepsy and intracranial infection,and those with higher EEG grade had lower modified GCS score.The prognosis was poor and left some sequelae for diffuse wave background,persistent diffuse epileplamptic or intermittent focal epileplamptic discharges.Sex,age of onset,etiology,and cEEG eclampsia discharge were compared in the dead and surviving groups,and there was no significant difference(P>0.05).Conclusion The cEEG can early detect abnormal EEG in critical children with secondary brain dysfunction,and further evaluate the degree of brain injury by continuous monitoring of brain function changes.
作者
张靖雯
萧潇
艾戎
孙慧
成善青
刘维亮
钱娜
田宜
杨柳
王凌
ZHANG Jingwen;XIAO Xiao;AI Rong;SUN Hui;CHENG Shanqing;LIU Weiliang;QIAN Na;TIAN Yi;YANG Liu;WANG Ling(Department of Pediatrics,the Affiliated Hospital of Guizhou Medical University,Guiyang 550004,Guizhou,China)
出处
《贵州医科大学学报》
CAS
2022年第7期816-820,共5页
Journal of Guizhou Medical University
基金
贵州省省长资金临床应用课题专项研究(2012118)。
