中国小儿急救医学
中國小兒急救醫學
중국소인급구의학
CHINESE PEDIATRIC EMERGENCY MEDICINE
2015年
7期
478-481,485
,共5页
振幅整合脑电图%缺氧缺血性脑病%亚低温
振幅整閤腦電圖%缺氧缺血性腦病%亞低溫
진폭정합뇌전도%결양결혈성뇌병%아저온
Amplitude-integrated electroencephalogram%Hypoxic-ischemic encephalopathy%Hypo-thermia
目的：研究振幅整合脑电图(amplitude-integrated electroencephalogram,aEEG)监测在缺氧缺血性脑病(hypoxic ischemic encephalopathy,HIE)诊断的价值及亚低温治疗 HIE 时 aEEG 的变化,评价亚低温治疗效果。方法连续监测亚低温治疗前后 aEEG 的变化,分析 aEEG 各种波形出现的比例。结果共90例患儿纳入研究,其中 aEEG 正常43例；轻度异常33例,重度异常14例。aEEG 监测结果与 HIE 临床分度及头颅 MRI 检查结果具有较高的一致性(Kappa ﹦0.584,P 〈0.001；Kappa ﹦0.590,P 〈0.001)。aEEG 对预测 HIE 轻重程度的敏感性、特异性、阳性预测值、阴性预测值均较高。轻度及重度异常 aEEG 亚低温治疗前后差异有统计学意义(P 〈0.05)。结论 aEEG 对 HIE 的早期诊断及轻重程度判断具有较优的评价效果。亚低温可明显降低 HIE 后异常 aEEG 出现的比例,具有神经保护作用,对轻中度 HIE 治疗效果明显。
目的：研究振幅整閤腦電圖(amplitude-integrated electroencephalogram,aEEG)鑑測在缺氧缺血性腦病(hypoxic ischemic encephalopathy,HIE)診斷的價值及亞低溫治療 HIE 時 aEEG 的變化,評價亞低溫治療效果。方法連續鑑測亞低溫治療前後 aEEG 的變化,分析 aEEG 各種波形齣現的比例。結果共90例患兒納入研究,其中 aEEG 正常43例；輕度異常33例,重度異常14例。aEEG 鑑測結果與 HIE 臨床分度及頭顱 MRI 檢查結果具有較高的一緻性(Kappa ﹦0.584,P 〈0.001；Kappa ﹦0.590,P 〈0.001)。aEEG 對預測 HIE 輕重程度的敏感性、特異性、暘性預測值、陰性預測值均較高。輕度及重度異常 aEEG 亞低溫治療前後差異有統計學意義(P 〈0.05)。結論 aEEG 對 HIE 的早期診斷及輕重程度判斷具有較優的評價效果。亞低溫可明顯降低 HIE 後異常 aEEG 齣現的比例,具有神經保護作用,對輕中度 HIE 治療效果明顯。
목적：연구진폭정합뇌전도(amplitude-integrated electroencephalogram,aEEG)감측재결양결혈성뇌병(hypoxic ischemic encephalopathy,HIE)진단적개치급아저온치료 HIE 시 aEEG 적변화,평개아저온치료효과。방법련속감측아저온치료전후 aEEG 적변화,분석 aEEG 각충파형출현적비례。결과공90례환인납입연구,기중 aEEG 정상43례；경도이상33례,중도이상14례。aEEG 감측결과여 HIE 림상분도급두로 MRI 검사결과구유교고적일치성(Kappa ﹦0.584,P 〈0.001；Kappa ﹦0.590,P 〈0.001)。aEEG 대예측 HIE 경중정도적민감성、특이성、양성예측치、음성예측치균교고。경도급중도이상 aEEG 아저온치료전후차이유통계학의의(P 〈0.05)。결론 aEEG 대 HIE 적조기진단급경중정도판단구유교우적평개효과。아저온가명현강저 HIE 후이상 aEEG 출현적비례,구유신경보호작용,대경중도 HIE 치료효과명현。
Objective To evaluate the values of amplitude-integrated electroencephalogram(aEEG) on the diagnosis of hypoxic ischemic encephalopathy(HIE),and the changes of aEEG in HIE with hypother-mia treatment.And to assess the therapeutic effect of hypothermia.Methods The changes of aEEG were continuously monitored before and after hypothermia treatment,and the proportions of various waveforms ap-pearing in aEEG were analyzed.Results A total of 90 cases were enrolled in this study,the changes of aEEG were monitored,including aEEG normal in 43 cases,mild abnormalities in 33 cases and severe abnor-malities in 14 cases.aEEG monitoring had a higher consistency with HIE grade and cranial MRI examination (Kappa ﹦0.584,P 〈0.001 ;Kappa ﹦0.590,P 〈0.001 ).The sensitivity,specificity,positive predictive val-ue,and negative predictive values of aEEG were high in predicting the severity of HIE.The index of with mild and severe abnormalities of aEEG was significant difference before and after the treatment of hypother-mia(P 〈0.05).Conclusion aEEG has a better evaluation effect on early diagnosis and severity assessing of HIE.Hypothermia can significantly reduce the proportion of abnormal aEEG after HIE,have a neuroprotective effect on the treatment of mild to moderate HIE.
