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目的探讨振幅整合脑电图(aEEG)对新生儿脑损伤的早期诊断价值。方法以新生儿重症监护病房(NICU)住院的190例脑损伤高危因素新生儿为研究对象(分窒息组和非窒息组),在出生后3~24h行aEEG监测,并对监测结果与脑损伤及缺氧缺血性脑病(HIE)的严重程度进行相关性分析。结果窒息组确诊HIE 65例(76.5%),窒息组aEEG总异常率为56.5%,HIE组aEEG异常率为73.8%(48/65),远高于无HIE组的aEEG异常率),aEEG异常率与HIE密切相关;非窒息组确诊新生儿脑损伤49例(46.7%),aEEG异常率为43.8%,脑损伤组aEEG异常率较高(89.3%),aEEG异常率与脑损伤密切相关。轻、中、重度HIE患儿aEEG异常率分别为63.4%、90.0%和100%,异常率有随临床分度而增加趋势,HIE临床分度与aEEG异常程度密切相关。结论新生儿脑损伤与aEEG异常率密切相关,且异常程度与HIE临床分度密切相关,对新生儿脑损伤早期诊断有重要价值。
Objective To investigate the early diagnostic value of amplitude-integrated electroencephalography (aEEG) in neonatal brain injury. Methods A total of 190 newborns with high risk of brain injury hospitalized in Neonatal Intensive Care Unit (NICU) were enrolled in this study. The aEEG monitoring was performed at 3 to 24 hours after birth. The monitoring results were compared with those of brain injury And the severity of hypoxic-ischemic encephalopathy (HIE) were analyzed. Results In the asphyxia group, 65 cases (76.5%) were confirmed as HIE, 56.5% as aEEG in asphyxia group and 73.8% (48/65) in HIE group, which was much higher than that of aEEG without HIE group There were 49 cases (46.7%) with neonatal brain injury confirmed by non-asphyxia group, 43.8% with aEEG abnormality group, and 89.3% with aEEG abnormality group. The abnormal rate of aEEG was closely related to brain injury. The abnormal rates of aEEG in children with mild, moderate and severe HIE were 63.4%, 90.0% and 100%, respectively. The abnormal rate increased with the clinical classification. The clinical classification of HIE was closely related to the abnormality of aEEG. Conclusion Neonatal brain injury is closely related to the abnormal rate of aEEG, and the abnormality is closely related to the clinical index of HIE. It is of great value in the early diagnosis of neonatal brain injury.