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目的 探讨视诱发电位在早产儿的应用及临床意义。方法 早产儿共 76例 ,其中实验组 2 1例 ,对照组 5 5例。两组患儿均在生后 7～ 14d行视觉诱发电位 (VEP)检查 ,实验组还同时进行了脑干听觉诱发电位(BAEP)检查。同时检测了 2 6例足月儿 ,与对照组早产儿进行比较。对异常者在生后 3个月、6个月进行了随访。结果 早产儿与足月新生儿一样 ,VEP波形及各波潜伏期已基本稳定 ,重复性好 ,尤以P1波检出率为10 0 %。孕周与P1波潜伏期两者密切相关。实验组患儿同时进行VEP和BAEP检查 ,两种检查方法无显著差异。实验组患儿P1潜伏期均明显长于相应孕周对照组 (P <0 0 5 ) ;其中实验组 15例早产儿异常 ,VEP主要改变既有单、双侧主波缺失、又有主波潜伏期延长。对VEP异常者随访发现 ,实验组 15例VEP异常患儿中 9例 (9/12 ,3例失访 )及对照组 4例异常者均在生后 3个月恢复正常。结论 VEP在早产儿的检查客观、准确。其波形可作为早产儿脑发育成熟的指标。主波缺失 (包括单、双侧 )被认为是严重异常 ,提示预后较差。
Objective To investigate the application and clinical significance of visual evoked potential in premature infants. Methods A total of 76 preterm infants, including experimental group 21 cases, control group 55 cases. Both groups of children underwent visual evoked potential (VEP) examination 7 ~ 14 days after birth, the experimental group also conducted brainstem auditory evoked potential (BAEP) examination. Twenty-six full-term infants were tested at the same time and compared with the control group. The abnormal persons were followed up 3 months and 6 months after birth. Results Like preterm infants, full-term newborns, VEP waveform and latency of each wave were basically stable with good repeatability, especially the detection rate of P1 wave was 100%. Both gestational age and P1 wave latency are closely related. The children in the experimental group also had VEP and BAEP examination at the same time. There was no significant difference between the two methods. The latent period of P1 in the experimental group was significantly longer than that of the corresponding gestational week control group (P <0.05). Among the 15 experimental group, the abnormality of the premature infant was the main change of VEP. Both single and bilateral main wave deletion, . Follow-up of abnormal VEP found that in the experimental group, 9 cases (9/12, 3 cases lost) of abnormal VEP in the experimental group and 4 cases in the control group returned to normal after 3 months. Conclusion VEP is objective and accurate in preterm infants. Its waveform can serve as an indicator of brain development in premature infants. Missing primary wave (including single and bilateral) is considered as a serious abnormality, suggesting a poor prognosis.