长时程脑电监测对评估HIE预后的价值

目的:探讨脑电图(EEG)长时程监测对新生儿缺氧缺血性脑病(HIE)预后的临床价值。方法:对在我院高危儿室住院的52例HIE的患儿进行12～24 h的EEG监测,将其脑电信息储存,采用(日)福山幸夫"新生儿异常EEG"诊断标准进行回放分析。并随访35例患儿,对预后进行评估。结果:52例患儿中,35例表现为不同程度的背景脑电活动降低,异常率占67%,且临床为中、重型HIE患儿的EEG异常率(100%),明显高于轻型HIE患儿的异常率(39%)(P<0.01)。EEG表现为中、高度背景脑电活动降低者,留有后遗症的几率(8/24,33%)高于轻型EEG背景活动降低者的几率(2/28,7%)(P<0.05)。在出生>1周后的新生儿。EEG仍表现为中、高度背景脑电活动降低的患儿,留有癫癎、脑瘫的几率(11例均有后遗症)明显高于出生后1周内背景脑电活动降低患儿的几率(4/13,31%) (P<0.01)。结论:EEG表现为轻度背景脑电活动降低者,预后良好,中度背景脑电活动降低者预后不良,高度背景脑电活动降低者预后极差。因此长时程脑电监测对新生儿HIE诊断及预后的评估具有重要意义。

To evaluate prognosis of HIE neonates by long-term EEG moritoring

Objective:To explore the clinical value of long-term EEG moritoring in neonates with hypoxia ischemia encephalopathy(HIE).Methods:Long-term EEG moritoring was performed in danger- ous neonates with HIE.Of 52 children patients,35 cases showed brain electric activity lowering,and the abnormal EEGs combined with clinical prognosis of the HIE neonates were analysed.Results:The EEG activity were decreased in 35 of 52 neonates.And the abnormality rate of EEG was 67%,that in moder- ate and severe HIE neonates(100%)were higher than those in light HIE neonates(39%)(P<0.01). The sequela incidence(33%)of EEG activity middle or obvious decrease in EEG was higher than that (7%)of light decrease in EEG activity(P<0.05).As compared with abnormal EEGs in the 1~(st) week only,the sequela incidence of epilepsy or cerebral palsy of neonates with abnormal EEGs still in the 2~(nd) week or later prominently increased(P<0.01).Conclusions:The prognosis of neonates with light de- crease in EEG activity was good,that of neonates with moderate decrease in EEG activity was bad,and that of neonates with obvious abnormal EEGs was the worst.Therefore,long-term EEG moritoring plays an important role in diagnosis and evaluating prognosis of neonate HIE.