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目的:对新生儿缺氧缺血性脑病(HIE)患儿进行随访观察,以评价其脑电图(EEG)在判断HIE后期的神经心理发育中的价值。方法:采用首都儿科研究所与中科院心理研究所编制的0～4岁小儿神经精神发育诊断量表,根据HIE新生儿的脑电图结果将出生7天内首次脑电图描记正常、轻度异常、异常分为A、B、C组;出生7天后首次脑电图描记正常、轻度异常、异常分为D、E、F组,每组均为30例,比较各组患儿6月龄时智能发育的差异。结果:出生7天内HIE患儿首次脑电图检测异常率高为70.3%。不同组别的患儿在6月龄时其总发育商比较差异有非常显著性(P<0.001),出生7天后EEG异常(F组)与出生7天内EEG异常(C组)比较差异有非常显著性(P<0.01)。出生7天内首次脑电图(EEG)正常的患儿其6月龄时总发育商分值最高,出生7天后EEG异常的总发育商分值最低,出生7天内EEG异常患儿6月龄时总发育商在中下水平,出生7天后EEG正常(D组)与出生7天内EEG轻度异常(B组)、出生7天后EEG轻度异常(E组)的患儿6月龄时总发育商比较差异无显著性(P>0.05)。结论:新生儿期脑电图检测结果结合首次检查时间可预测6月龄时智能发育水平,新生儿EEG可作为HIE早期判断后期神经心理发育的一种有效、方便的检查手段,可为临床判断提供依据,促进早期干预。
Objective: To observe the value of EEG in judging the neuropsychological development of late stage of HIE in children with neonatal hypoxic-ischemic encephalopathy (HIE). Methods: According to the diagnostic value of neuropsychological development of children aged 0 ~ 4 years prepared by Capital Institute of Pediatrics and Chinese Academy of Sciences Institute of Psychology, according to the EEG results of neonates of HIE, the first EEG images were normal and mild within 7 days of birth, The abnormalities were divided into groups A, B and C. The first EEG was normal and mild abnormalities after 7 days of birth, and the abnormalities were divided into D, E and F groups, with 30 cases in each group. At 6 months of age Differences in intelligent development. Results: The abnormal rate of the first EEG examination in HIE children was 70.3% within 7 days of birth. Children of different groups showed significant difference in total developmental age at 6 months of age (P <0.001), abnormal EEG at 7 days after birth (Group F) and abnormal EEG at 7 days of birth (Group C) Significance (P <0.01). Children with normal EEG for the first time within 7 days of birth had the highest total developmental score at 6 months of age, the lowest total developmental scores of EEG abnormalities after 7 days of birth, children with EEG abnormalities at 6 months of age at 7 days of birth Total development was at middle and lower levels, with normal EEG (group D) after 7 days of birth and mild abnormalities of EEG within 7 days of birth (group B), total edema at 6 months of age in children with mild EEG at 7 days after birth (group E) The difference was not significant (P> 0.05). Conclusion: Neonatal electroencephalogram (EEG) combined with the first examination time can predict the level of intelligence development at 6 months of age. Neonatal EEG can be used as an effective and convenient means to check neuropsychological development in early stage of HIE, which can be used as clinical judgment Provide the basis for promoting early intervention.