中国小儿急救医学
中國小兒急救醫學
중국소인급구의학
CHINESE PEDIATRIC EMERGENCY MEDICINE
2012年
3期
253-255
,共3页
孙先军%杨建军%连鹏强%范秀玖%杨梅
孫先軍%楊建軍%連鵬彊%範秀玖%楊梅
손선군%양건군%련붕강%범수구%양매
Apgar评分%新生儿窒息%振幅整合脑电图%缺氧缺血性脑病%婴儿,新生
Apgar評分%新生兒窒息%振幅整閤腦電圖%缺氧缺血性腦病%嬰兒,新生
Apgar평분%신생인질식%진폭정합뇌전도%결양결혈성뇌병%영인,신생
Apgar score%Neonatal asphyxia%Amplitude-integrated electroencephalogram%Hypoxicischemic encephalopathy%Infant,newborn
目的 了解不同Apgar评分新生儿振幅整合脑电图(amplitude-integrated electroencephalogram,aEEG)的变化,探讨aEEG对窒息新生儿缺氧缺血性脑病(hypoxic-ischemic encephalopathy,HIE)的诊断价值.方法 2010年12月至2011年10月对我院新生儿病房住院的56例不同Apgar评分足月患儿,根据生后1 min Apgar评分将患儿分为观察组(Apgar评分0～7分)36例,对照组(Apgar评分8 ～10分)20例.分别在生后6h内、2d、3d、7d对患儿进行aEEG描记,分析aEEG的变化及其对新生儿HIE的诊断价值.结果 对照组20例患儿生后6h aEEG正常17例(85％)、轻度异常3例(15％),无重度异常；观察组36例患儿中,生后6 h aEEG正常18例(50％),轻度异常13例(36.1％),重度异常5例(13.9％),观察组aEEG异常率显著高于对照组(x2=5.3,P＜0.001).观察组36例患儿中,34例诊断为HIE,生后6 h aEEG监测结果与HIE临床分度有相关性(Spearman等级相关系数为0.867,P＜0.01).动态aEEG监测56例患儿,生后6h有21例aEEG异常,其中15例(71.4％)患儿于病程48～72h aEEG恢复正常,有4例(7.1％)第7天aEEG呈重度异常.结论 对足月HIE新生儿进行生后动态aEEG监测,能早期预测HIE病情轻重程度.
目的 瞭解不同Apgar評分新生兒振幅整閤腦電圖(amplitude-integrated electroencephalogram,aEEG)的變化,探討aEEG對窒息新生兒缺氧缺血性腦病(hypoxic-ischemic encephalopathy,HIE)的診斷價值.方法 2010年12月至2011年10月對我院新生兒病房住院的56例不同Apgar評分足月患兒,根據生後1 min Apgar評分將患兒分為觀察組(Apgar評分0～7分)36例,對照組(Apgar評分8 ～10分)20例.分彆在生後6h內、2d、3d、7d對患兒進行aEEG描記,分析aEEG的變化及其對新生兒HIE的診斷價值.結果 對照組20例患兒生後6h aEEG正常17例(85％)、輕度異常3例(15％),無重度異常；觀察組36例患兒中,生後6 h aEEG正常18例(50％),輕度異常13例(36.1％),重度異常5例(13.9％),觀察組aEEG異常率顯著高于對照組(x2=5.3,P＜0.001).觀察組36例患兒中,34例診斷為HIE,生後6 h aEEG鑑測結果與HIE臨床分度有相關性(Spearman等級相關繫數為0.867,P＜0.01).動態aEEG鑑測56例患兒,生後6h有21例aEEG異常,其中15例(71.4％)患兒于病程48～72h aEEG恢複正常,有4例(7.1％)第7天aEEG呈重度異常.結論 對足月HIE新生兒進行生後動態aEEG鑑測,能早期預測HIE病情輕重程度.
목적 료해불동Apgar평분신생인진폭정합뇌전도(amplitude-integrated electroencephalogram,aEEG)적변화,탐토aEEG대질식신생인결양결혈성뇌병(hypoxic-ischemic encephalopathy,HIE)적진단개치.방법 2010년12월지2011년10월대아원신생인병방주원적56례불동Apgar평분족월환인,근거생후1 min Apgar평분장환인분위관찰조(Apgar평분0～7분)36례,대조조(Apgar평분8 ～10분)20례.분별재생후6h내、2d、3d、7d대환인진행aEEG묘기,분석aEEG적변화급기대신생인HIE적진단개치.결과 대조조20례환인생후6h aEEG정상17례(85％)、경도이상3례(15％),무중도이상；관찰조36례환인중,생후6 h aEEG정상18례(50％),경도이상13례(36.1％),중도이상5례(13.9％),관찰조aEEG이상솔현저고우대조조(x2=5.3,P＜0.001).관찰조36례환인중,34례진단위HIE,생후6 h aEEG감측결과여HIE림상분도유상관성(Spearman등급상관계수위0.867,P＜0.01).동태aEEG감측56례환인,생후6h유21례aEEG이상,기중15례(71.4％)환인우병정48～72h aEEG회복정상,유4례(7.1％)제7천aEEG정중도이상.결론 대족월HIE신생인진행생후동태aEEG감측,능조기예측HIE병정경중정도.
Objective To observe the changes of amplitude-integrated electroencephalogram (aEEG)of neonatal asphyxia with different Apgar scores,and to investigate the diagnostic value of aEEG for hypoxicischemic encephalopathy(HIE) in neonatal asphyxia.Methods aEEG monitoring were detected on 56 fullterm asphyxia neonates who were hospitalized in our neonatal department from Dec 2010 to Oct 2011.According to 1 minute Apgar score after birth,56 cases were divided into two groups:observation group in which 36 cases with Apgar score 0～7,and control group in which 20 cases with Apgar score 8～10.aEEG monitoring was done within 6 h,2 d,3 d,7 d of each neonates after birth,and the changes of aEEG were analyzed and the diagnostic value on HIE were evaluated.Results Among 20 cases in the control group,the aEEG results in 6 hours after birth were 17 cases (85％) had normal aEEG results,3 cases( 15％ ) mildly abnormal,nd no one severely abnormal.The aEEG results of patients in observation group(36 cases) were 18 cases(50％ ) had normal aEEG results,13 cases(36.1％ ) mildly abnormal,and 5 cases( 13.9％ ) severely abnormal.The abnormal rate in observation group was significantly higher than that of the control group ( x2=5.3,P＜0.001 ).There were 34 HIE patients in the total 36 cases of observation group,whose aEEG monitoring results in 6 hours after birth were associated with HIE clinical grading( Spearman's rank correlation coefficient was 0.867,P＜0.01 ).Dynamic aEEG monitoring for 56 patients showed that 21 cases had abnormal aEEG in 6 hours after birth,in whom 15 cases(71.4％ ) could returned to normal after 48～72 hours after birth,and there were only 4 case (7.1％ ) still had severely abnormal aEEG results in the seventh day after birth.Conclusion The aEEG dynamic monitoring for full-term HIE neonates after birth enhances early prediction of HIE.
