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目的探讨脑电图(EEG)背景活动在早产儿脑损伤中的应用价值。方法选择2008年11月至2010年10月我院新生儿重症监护病房诊断为脑损伤的早产儿为病例组,分为轻度脑损伤组(包括脑室内出血Ⅰ级和Ⅱ级,脑室周围白质软化Ⅰ级和Ⅱ级)和重度脑损伤组(包括脑室内出血Ⅲ级和Ⅳ级,脑室周围白质软化Ⅲ级和Ⅳ级),同期选择无脑损伤的早产儿为对照组,各组早产儿均于生后3～28天进行EEG测试,比较各组脑电图结果以及脑损伤程度与EEG结果的相关性。结果重度脑损伤组(11例)和轻度脑损伤组(56例)最大背景抑制间期、非连续背景活动暴发间隔时间、交替性背景活动期最长暴发间隔时间和暴发段振幅均值、静态睡眠期持续慢波睡眠振幅、清醒期振幅等均高于对照组(93例),差异有统计学意义(P<0.05),且重度脑损伤组高于轻度脑损伤组(P<0.05)。生后4周内EEG异常程度与脑损伤程度正相关(r=0.727,P<0.05)。病例组随访53例,轻度脑损伤组EEG恢复率明显高于重度脑损伤组(88.4%比50.0%,P<0.05)。结论脑损伤程度越重的早产儿EEG背景改变越明显,脑电图背景活动应用于早产儿脑损伤,能客观评价脑功能发育状态。
Objective To investigate the value of EEG background activity in premature infants with brain injury. Methods From November 2008 to October 2010 in our hospital neonatal intensive care unit diagnosed as brain injury in preterm children as a case group, divided into mild brain injury group (including intraventricular hemorrhage Ⅰ and Ⅱ grade, periventricular leukomalacia Grade Ⅰ and Ⅱ) and severe brain injury group (including grade Ⅲ and Ⅳ of intraventricular hemorrhage, grade Ⅲ and Ⅳ of periventricular leukomalacia). Preterm infants without brain injury were selected as the control group in the same period. 3 to 28 days after birth, EEG test was performed to compare the EEG results of each group and the correlation between the degree of brain injury and EEG results. Results The maximum background suppression interval, discontinuous background activity interval, the longest interval of alternating background activity and the amplitude of the amplitude of the outbreak in severe brain injury group (11 cases) and mild brain injury group (56 cases) The amplitude of sustained slow wave sleep during sleep and the amplitude of awake period were higher than that of control group (93 cases), the difference was statistically significant (P <0.05), and severe brain injury group was higher than mild brain injury group (P <0.05) . EEG abnormalities within 4 weeks after birth were positively correlated with the degree of brain injury (r = 0.727, P <0.05). The cases were followed up 53 cases, mild brain injury EEG recovery was significantly higher than severe brain injury (88.4% vs 50.0%, P <0.05). Conclusions The more severe the brain damage is, the more obvious the changes of EEG background are. The background activity of EEG is applied to brain injury in premature infants, which can objectively evaluate the development of brain function.