动态脑电图对新生儿惊厥的诊断与预后评估

【摘要】目的评价动态脑电图(AEEG)在新生儿惊厥中的应用价值。方法广东省肇庆市第一人民医院于2001 10—2005 10，应用AEEG检测仪对46例 惊厥发作的新生儿进行AEEG监测分析，并随访6个月至2年。结果46例惊厥新生儿AEEG监测正常30例(65.2%),异常16例(34.8%)。重度异常AEEG特 点为发作期惊厥性放电者8例，发作间期惊厥性放电2例,低电压2例;轻度异常为4例，表现为缺甲图形变化3例,一过性尖波增多1例。该组睡眠期 惊厥性放电出现的频率增高,尤其在安静睡眠期多见(5/7，71.4%)。随访4例轻度AEEG异常患儿预后正常；12例重度AEEG异常有9例出现后遗症, 表现为运动智力低下,脑瘫，癫疒间。结论AEEG监测对于新生儿惊厥性疾病的诊断与预后的估计具有较好的应用价值,AEEG异常程度越重则临床 后遗症明显。     

孕妇与新生儿血清铅及其相关性研究

为了解孕妇日常生活中铅暴露及对宫内胎儿有何影响 ,我们对 30例未婚女青年和 6 0例孕妇血清及其新生儿脐血清铅含量进行了测定 ,并对相互间关系进行了研究。1　资料与方法1.1　研究对象　 30例未婚女青年和 6 0例孕妇 ,平素健康。家住济南市区 ,从事非铅污染工作 ,无吸烟等不良嗜好。 6 0例孕妇均为足月初产 ,其 6 0例新生儿体重均在正常范围。1.2　方法1.2 .1　所有未婚女青年均采集静脉血 ,所有孕妇均于临床分娩前采集静脉血 ,并于胎儿娩出后立即采集脐带血 3mL ,分离血清备测。1.2 .2　血清铅测定　采用三电极直流等离子体 -原子发射光…     

新生儿缺氧缺血性脑损伤程度与血清乳酸脱氢酶同工酶及CT值的关系

新生儿缺氧缺血性脑病 (hypoxic ischem ic ence-phalopathy,HIE)脑损伤程度、预后的早期判断 ,及时合理的治疗仍然是我国围产医学的突出问题。血清乳酸脱氢酶同工酶 (lactate dehydrogenase isoenzym es,L DHi)在参与细胞氧代谢中的变化较灵敏的反映了新生儿脑缺氧的状况。头颅CT对 HIE的诊断具有公认的重要价值。为了客观、全面的早期评价 HIE程度、预后并及时合理的治疗 ,我们将血清L DHi监测与脑实质 CT值结合 ,临床应用结果分析如下。一、对象和方法1.对象 :足月、正常体重 HIE新生儿 5 1例 ,男 36例 ,女15例 ;出生时重度窒息…     

产妇与新生儿血清甲状腺激素水平的相关性研究

目的　探讨产妇血清促甲状腺激素 (TSH)水平与其新生儿脐血TSH水平之间的关系。方法　应用免疫放射分析 (IRMA)法测定了 5 0 0例缺碘地区产妇及其新生儿 (研究组 )血清TSH水平 ,同时选择 10 0例非缺碘地区产妇及其新生儿作为对照组。结果　 (1)研究组产妇TSH均值为 (5 .2 5±2 .43)mU/L ,对照组为 (4.6 9± 1.34 )mU/L。研究组新生儿TSH均值为 (6 .83± 4.71)mU/L ,对照组为(5 .32± 3.0 2 )mU/L。 (2 )两组产妇及其新生儿TSH水平呈显著正相关。 (3)两组产妇TSH水平和其游离三碘甲腺原氨酸 (T3 )水平呈显著负相关。结论　监测产妇的TSH水平可评估其新生儿的碘营养状况。     

围产期窒息新生儿血清胱抑素C的变化及临床意义的研究

胱抑素C(cystain C)为一种低分子量蛋白质，近年国内外研究表明其血清浓度与肾小球滤过率(GFR)密切相关，本研究旨在通过观察不同胎龄新生儿及围产期窒息新生儿血清CysC、肌酐(Cr)和尿素氮(BUN)的变化，研究CysC与上述指标的关系并探讨其评价新生儿肾功能的价值。     

新生儿溶血病与孕妇血清中IgG亚型关系的研究

目的：在已知孕妇血清中IgG抗A（B）效价和其新生儿是否发生HDN的基础上,来探讨孕妇血清中抗A（B）IgG亚型与HDN之间的关系。希望所获得的结果能够弥补目前临床常用的检测O型孕妇体内的抗A03）IgG的效价来预报ABO血型不合HDN的方法的不足,并为临床提供更加有效的预报ABO血型不合HDN的方法。方法：收集2007年10月～2009年5月,在梨园医院输血科进行检查的45例夫妇血型不合。型RhD（＋）孕妇及与其相应的新生儿标本。结果：对孕妇血清中抗A（B）IgG效价进行检测后表明：抗A（B）IgG抗体量与溶血程度有一定的相关性,但并非绝对;不能单纯以孕妇血清抗体效价的高低作为判断胎儿病情是否严重的唯一诊断依据。结论：本实验通过ELISA方法检测孕妇和新生儿血清中抗A03）IgG亚型,发现。型孕妇血清中抗A（B）IgG1是引起ABO血型不合HDN的重要因素,因而检测孕妇体内各IgG亚型的含量比检测抗A03）IgC效价更能准确地预报HDN的发生,并可以指导临床采取有效的预防和治疗措施。     

父平支原体感染与新生儿感染关系的研究

目的：探讨父母解脲支原体（ＵＵ）感染与新生儿ＵＵ感染的关系，以及新生儿ＵＵ感染与分娩的关系。方法；于１９９５年７－１２月应用聚合酶链反应（ＰＣＲ）技术对１５７例孕妇宫颈管分泌物拭标本作ＵＵ检测，是性者分别其丈夫尿道分泌道分泌物和新生鼻咽部分拭了作ＵＵ检测，结果：孕妇ＵＵ阳性率１７．２％；ＵＵ阳性孕妇之丈夫及其新生儿ＵＵ阳性率分别为６６．７％及５５．６％；其中仅母亲阳性的新生儿ＵＵ阳性２例，父母ＵＵ     

新生儿窒息后Tei指数与血清心肌酶的关系

目的 探讨新生儿窒息后Tei指数与血清心肌酶的关系.方法 超声心动图测定44例轻度窒息新生儿、27例重度窒息新生儿及20例正常新生儿的二尖瓣口舒张期血流频谱E峰、A峰及E/A值、左心室射血分数、等容收缩间期、等容舒张间期及Tei指数,同时取其静脉血测定天冬氨酸氨基转移酶、肌酸激酶及其同工酶、乳酸脱氢酶、羟丁酸脱氢酶和肌钙蛋白T水平.组间差异比较采用单因素方差分析,两两比较用q检验,Tei指数与血清心肌酶间的关系采用直线相关分析.结果 (1)Tei指数、等容收缩间期及等容舒张间期在重度窒息组分别为0.62±0.13、(47±7)ms和(52±8)ms,均高于轻度窒息组[分别为0.51±0.14、(41±6)ms和(43±6)ms],轻度窒息组高于正常对照组[分别为0.39±0.12、(34±6)ms和(37±6)ms],差异均有统计学意义(P均<0.01).(2)天冬氨酸氨基转移酶、肌酸激酶及其同工酶、乳酸脱氢酶、羟丁酸脱氢酶和肌钙蛋白T在轻度窒息组高于正常对照组(P<0.01),重度窒息组高于轻度窒息组(P<0.01).(3)Tei指数、等容收缩间期及等容舒张间期均与血清心肌酶水平呈正相关(P<0.01).其中Tei指数与肌酸激酶及其同工酶和肌钙蛋白T相关性更明显(r分别为0.762、0.821、0.778,P均<0.01).结论 Tei指数可与血清心肌酶联合应用,评价新生儿窒息后心肌损害患儿的心脏功能,更可准确和动态监测与评估心功能不全的程度.     

新生儿窒息后Tei指数与血清心肌酶的关系

Objective To study the relationship between Tei index and the myocardial enzymes in newborns with myocardial damage due to asphyxia. Methods Forty-four newborns with mild asphyxia,27 newborns with severe asphyxia and 20 healthy newborns hospitalized in our hospital from January 2005 to December 2008 were enrolled in this study.The peak E and peak A and E/A ratio at mitral valve,the ejection fraction,isovolumetric contraction time,isovolumetric relaxation time and Tei index were measured by conventional echocardiography,and aspartate aminotransferase,creatine kinase,lactate dehydrogenase,hydroxybutyrate dehydrogenase and creatine phosphate kinase isoenzyme,and cardiac troponin T were tested also.One-way ANOVA was used to analyze the difference between groups. Results Tei index,isovolumetric contraction time and isovolumetric relaxation time in the severe asphyxia newborns were 0.62±0.13,(47±7)ms and(52±8)ms,higher than those in the mild asphyxia newborns[0.51±0.14,(41±6)ms and(43±6)ms],those in the mild asphyxia newborns were higher than in the healthy newborns[0.39±0.12,(34±6)ms and (37±6)ms] (all P<0.01).Aspartate aminotransferase,lactate dehydrogenase,hydroxybutyrate dehydrogenase,creatine kinase and its isoenzymes and cardiac troponin T in the severe asphyxia newborns were higher than in the mild asphyxia newborns and healthy group(P<0.01).Tei index,isovolumetric contraction time and isovolumetric relaxation time were positively related to the myocardial enzymes.The positive relationships were more statistically significant in Tel index,creatine kinase,its isoenzymes and cardiac troponin T(r=0.762,0.821,0.778,P<0.01).Conclusions Combination of Tei index and myocardial enzymes can not only be applied to assess the cardiac function in newborns with myocardial damage due to asphyxia,but also to evaluate the degree of cardiac dysfunction accurately and dynamically.     

新生儿窒息后Tei指数与血清心肌酶的关系

Objective To study the relationship between Tei index and the myocardial enzymes in newborns with myocardial damage due to asphyxia. Methods Forty-four newborns with mild asphyxia,27 newborns with severe asphyxia and 20 healthy newborns hospitalized in our hospital from January 2005 to December 2008 were enrolled in this study.The peak E and peak A and E/A ratio at mitral valve,the ejection fraction,isovolumetric contraction time,isovolumetric relaxation time and Tei index were measured by conventional echocardiography,and aspartate aminotransferase,creatine kinase,lactate dehydrogenase,hydroxybutyrate dehydrogenase and creatine phosphate kinase isoenzyme,and cardiac troponin T were tested also.One-way ANOVA was used to analyze the difference between groups. Results Tei index,isovolumetric contraction time and isovolumetric relaxation time in the severe asphyxia newborns were 0.62±0.13,(47±7)ms and(52±8)ms,higher than those in the mild asphyxia newborns[0.51±0.14,(41±6)ms and(43±6)ms],those in the mild asphyxia newborns were higher than in the healthy newborns[0.39±0.12,(34±6)ms and (37±6)ms] (all P<0.01).Aspartate aminotransferase,lactate dehydrogenase,hydroxybutyrate dehydrogenase,creatine kinase and its isoenzymes and cardiac troponin T in the severe asphyxia newborns were higher than in the mild asphyxia newborns and healthy group(P<0.01).Tei index,isovolumetric contraction time and isovolumetric relaxation time were positively related to the myocardial enzymes.The positive relationships were more statistically significant in Tel index,creatine kinase,its isoenzymes and cardiac troponin T(r=0.762,0.821,0.778,P<0.01).Conclusions Combination of Tei index and myocardial enzymes can not only be applied to assess the cardiac function in newborns with myocardial damage due to asphyxia,but also to evaluate the degree of cardiac dysfunction accurately and dynamically.     

视频脑电图在新生儿惊厥中的应用价值

目的评价数字化视频脑电图（video electroencephalogram，VEEG）在新生儿惊厥中的应用价值。方法应用数字化视频脑电图仪，对64例胎龄28～44周的新生儿惊厥发作进行VEEG监测并分析结果。结果正常脑电图43例（67．2％），异常脑电图21例（32．8％），其中以新生儿缺氧缺血性脑病、颅内出血等脑器质性病变癎性放电异常率最高。其中发作期癎性放电者13例；发作间期癎样放电3例，背景节律正常；背景节律改变伴有发作间期癎样放电2例；背景波改变3例，其中低电压1例，平坦波1例，交替现象消失1例。睡眠期癎性放电的放电频率比清醒期明显增高，且以安静睡眠期最为多见。18例VEEG同步监测到发作期癎性放电，其中16例（16／18）起始放电为局灶起源，以颞区为主（13／18）。共监测到46例新生儿发作，在发作期或／和发作间期VEEG检测均无癎性放电，确定为非癫癎性发作。结论VEEG对于新生儿惊厥发作性疾病的诊断和鉴别诊断具有重要价值，有利于早期治疗和改善预后。     

增生期血清泌乳素水平与多囊卵巢综合征不孕的关系探讨

研究多囊卵巢综合征不孕与增生期血清泌素的关系。方法采用放射免疫测定法测定血清泌乳素质量浓度。结果ＰＣＯＳ不孕组和非ＰＣＯＳ不孕组的增生期血清泌乳素水平无明显差异,但两组与生育组比较,血清乳素水平明显增高。     

To study the incidence,etiology and EEG profile of neonatal seizures: a prospective observational study from India

Aim: To study the incidence, etiology and electroencephalography (EEG) profile of neonatal seizures and also to study the correlation between clinical picture and EEG appearance.

Type of study: Prospective observational cohort study.

Study duration: September 2011 to April 2013.

Inclusion and exclusion: Seizures within first 28?d of life and seizures documented by doctors.

Population: Neonates admitted in intensive care unit: intramural (4412) and extramural (1900) admissions (all together 6312).

Materials and methods: One hundred and seventy-two neonates with seizures were enrolled. All the neonates were evaluated with necessary investigation, ultrasound head and CT scan. All the neonates underwent EEG as early as possible with neonatal stabilization. The etiology of neonatal seizures, CT scan and ultrasound head, characteristic of the EEG and neonatal mortality were noted.

Results: The incidence of neonatal seizure was 0.77% in the intramural and 7.3% among the extramural neonates. The incidence of seizures in term newborn was 0.7% and in preterm was 1.1%. The most common cause of neonatal seizure was hypoxic ischemic encephalopathy (HIE) followed by hypocalcemia. The predominant seizure type was multifocal (51%) followed by subtle seizure (43%). There was an EEG abnormality in 72% of the total EEG with varied patterns. The mortality rate in the cohort was 15% with HIE being the most common cause.

Conclusion: Most common cases of neonatal seizure were HIE and with the most common type being multifocal. EEG was abnormal in the majority of the neonates with various pattern of abnormality.     

The relationship between nucleated red blood cell counts and early-onset neonatal seizures

OBJECTIVE: This study was undertaken to better define the timing of neurologic insult in neonates with early-onset seizures through evaluation of neonatal nucleated red blood cell levels. STUDY DESIGN: Medical records and the International Classification of Diseases, Ninth Revision codes were used to identify all term neonates with neonatal convulsions who were delivered at our institution (January 1, 1990-December 31, 1995). Each neonate with early-onset seizures was matched to the next 3 neonates who met the following criteria: gestational age > or =37 weeks, no early-onset seizures, birth weight > or =800 g, umbilical artery pH > or =7.25, and a 5-minute Apgar score >7. Demographic characteristics, clinical factors, and mean initial nucleated red blood cell counts were compared between groups. RESULTS: During the 6-year study period, there were a total of 36, 490 singleton term deliveries of infants who were alive at birth. Forty-five (0.1%) of these neonates had early-onset seizures. Thirty neonates with early-onset seizures met the inclusion criteria. Mean nucleated red blood cell counts (number of nucleated red blood cells per 100 white blood cells) for neonates with early-onset seizures were significantly increased compared with those of control neonates (18.4 +/- 22.0 vs 4.6 +/- 4.5; P <.0008). CONCLUSIONS: Our findings are suggestive of the hypothesis that neurologic injury leading to early-onset seizures often occurs before the intrapartum period.     

控制性卵巢刺激治疗中血清催乳素水平的变化特点

目的 探讨控制性卵巢刺激(COS)治疗中血清催乳素水平的变化特点.方法 收集接收体外受精-胚胎移植的患者72例,共115个周期,采用促性腺激素释放激素激动剂结合促性腺激素(Gn)长、短方案促排卵治疗,定时经阴道B超监测卵泡发育情况及子宫内膜厚度,并采用酶联免疫发光法检测不同时间点血清雌二醇、黄体生成素(LH)、孕酮和催乳素的水平,分析患者雌二醇、LH、孕酮水平与催乳素水平之间的相关性.结果 对催乳素与雌二醇水平进行相关和回归分析发现,随着雌二醇水平的上升,催乳素水平有显著上升的趋势,两者呈显著正相关关系(r=0.5897,P＜0.01).对催乳素与孕酮水平进行相关和回归分析发现,孕酮水平随催乳素水平的升高而升高,两者呈显著正相关关系(r=0.1412,P＜0.01).但是LH水平与催乳素水平之间未见明显关联.结论 在控制性卵巢刺激治疗中,催乳素的分泌不受Gn的影响,而雌二醇水平的升高可能刺激催乳素的分泌,且催乳素与孕酮水平呈正相关关系.     

Relationship between serum prolactin, lactation and changes in maternal blood B-cell (CD19+) percents during the first 8 months post-partum

Lactation is an immunologically unique state when immune factors are produced by the mother for the protection of the infant rather than the mother. While several studies have focused on the immunological composition of human milk, much less information is available on maternal immune status during lactation. Sixty-four lactating and 43 bottlefeeding women at 1–2 weeks, 1, 2, 4 or 8 months post-partum were studied in a cross-sectional design, with 14 nulliparous women as controls. Flow cytometry analysis of peripheral blood lymphocytes showed dynamic, post-partum changes in the B-cell subpopulation. Among lactating women, the relative percents of CD19+ B-cells were significantly lower (P < 0.05) than control levels at 1–2 weeks and 1 month post-partum, but showed a significant, polynomial-linear rise (P < 0.05) over time, reaching control values by 2–4 months post-partum. Bottle-feeding women had an earlier rise in the percentage of CD 19 + cells, with relative percents always significantly higher than their lactating counterparts. The differing patterns may be due to changes in serum prolactin concentrations because, among the post-partum women, relative percents of CD19+ cells were negatively correlated with baseline serum prolactin concentrations. These results have implications for maternal immunization programs designed to enhance maternal and/or infant well-being as well as other maternal health effects related to breastfeeding.     

新生儿难治性惊厥的临床特征及预后相关因素

目的 探讨新生儿难治性惊厥的病因和临床特点,分析影响预后的因素. 方法 选取2000年1月1日至2011年7月31日在北京大学第一医院新生儿病房住院的临床诊断难治性惊厥新生儿46例,选取同期收治非难治性惊厥的新生儿惊厥患儿42例作为对照组,比较2组的病因、临床特点及预后.难治性惊厥患儿预后正常11例,预后不良35例,比较2组的病因及临床特点.应用卡方检验比较组间差异;应用Logistic多元回归分析发展为难治性惊厥的危险因素和影响难治性惊厥患儿预后的危险因素. 结果 (1)难治性惊厥患儿常见的病因为严重的围产期脑损伤(8/46,17.4％),脑结构发育异常(7/46,15.2％)和先天性代谢性疾病(3/46,6.5％).难治性惊厥患儿每日均有惊厥发作者占91.3％(42/46),脑电图重度异常者占55.6％(25/45),存在惊厥持续状态者占17.4％(8/46),预后不良者占76.1％(35/46),均明显高于非难治性惊厥患儿,分别为57.1％(24/42)、5.4％(2/37)、0.0％ (0/42)和21.4％(9/42),差异均有统计学意义(x2分别为13.665、23.123、Fisher精确概率法、26.236,P均＜0.01).脑电图重度异常(OR=16.384,95％CI:3.421～78.472,P=0.000)和每日均有惊厥发作(OR=3.811,95％CI:1.019～14.258,P=0.047)是发展为难治性惊厥的独立危险因素.(2)难治性惊厥患儿预后不良者苯巴比妥治疗无效的比例为80.0％(28/35),明显高于预后正常者的4/11,差异有统计学意义(Fisher精确概率法,P=0.010).苯巴比妥治疗无效也提示难治性惊厥患儿预后不良(OR=12.444,95％CI:2.530～61.217,P=0.002).结论 新生儿难治性惊厥的常见病因为严重的围产期脑损伤、脑结构发育异常及先天性代谢性疾病.其临床表现以频繁发作、易存在惊厥持续状态及脑电图重度异常为特点,常预后不良,对苯巴比妥的治疗反应欠佳提示预后不良.     

振幅整合脑电图对新生儿惊厥的评价意义

目的 研究振幅整合脑电图(amplitude integrated electroencephalogram,aEEG)对新生儿惊厥的评价意义.方法 对2008年7月至2009年7月于北京大学第一医院新生儿病房收治的32例新生儿惊厥患儿在同一天进行aEEG与视频脑电图(video electroencephalogram,VEEG)监测,分析aEEG脑电振幅波谱带、脑电背景节律及原始脑电信号,并与VEEG结果 进行对比.结果 有12例患儿在VEEG监测过程中有临床惊厥发作,在aEEG中均监测到,监测敏感性达100%;VEEG表现为发作间期放电的20例,aEEG监测的敏感性87%,特异性100%,阳性预测值100%,阴性预测值80%,但aEEG不能区分发作期放电或者发作间期放电.VEEG监测中背景活动异常的13例患儿,aEEG监测的敏感性100%,特异性83%,阳性预测值76%,阴性预测值100%.32例患儿在VEEG监测中均可见发作期或发作间期痫样放电,而aEEG的原始脑电亦能监测到,有3例患儿在aEEG整合后振幅波谱带中未监测到放电,但在原始脑电中能监测到.结论 aEEG对新生儿惊厥监测的敏感性和特异性比较理想,可以作为一种简单、可靠的新生儿惊厥的初步筛查方法.

Abstract：

Objective To study the evaluative values of amplitude integrated electroencephalogram (aEEG) in screening neonatal seizures.Methods The aEEG and video electroencephalogram (VEEG) on 32 patients with seizures hospitalized in Peking University First Hospital was conducted on the same day.The parameters of aEEG including the integrated spectra band,background rhythm and primitive electro signal were analyzed and compared with VEEG.Results Seizures presented clinically by 12 cases were detected by VEEG,and their electric discharges were detected by aEEG.The sensitivity of aEEG was 100%.VEEG showed electric discharges during intermediate stage in twenty cases and thus the seventeen of this group were detected by aEEG with its sensitivity of 87% and 100% in the specificity.The positive and negative predictive values of aEEG were 80% and 100%,respectively.But aEEG could not discriminate the attack stage or intermediate stage electric discharges.The abnormal background activity was detected by VEEG in 13 cases and the sensitivity of aEEG was 100% and the specificity was 83%.The positive and negative predictive value by aEEG were 76% and 100% respectively.The electric discharges of 32 cases were detected by VEEG whenever they were in attack stage or intermediate stage.All electric discharges could be detected through primitive electro signal by aEEG.The electric discharges in 3 cases were not detected by integrated spectra band from aEEG,but were detected by primitive electro signal from aEEG.Conclusions The sensitivity and specificity in the screening of neonatal seizures by aEEG is useful and could be applied clinically as a simple and safe screening method for recognizing neonatal seizures.     

同步视频脑电图监测下双导振幅整合脑电图诊断新生儿惊厥的价值

目的 探讨双导振幅整合脑电图(amplitude-integrated electroencephalogram,aEEG)(C3-C4/T3-T4)附加对应的双导原始脑电图(electroencephalogram,EEG)诊断新生儿惊厥的价值及局限性. 方法 2011年1月至7月,对66例入住复旦大学附属儿科医院的临床有惊厥发作或可疑惊厥发作的新生儿,进行床旁视频脑电图(video electroencephalogram,VEEG)监测,时间≥3h.通过Galileo NT PMS软件将原始EEG转化为3种形式aEEG,即单导aEEG(C3-C4)、单导aEEG(C3-C4)附加原始EEG、双导aEEG(C3-C4/T3-T4)附加原始EEG.EEG和aEEG分开判读,VEEG需标记电发作(≥10 s)起始放电灶及放电持续时间,aEEG只进行电发作标记.以VEEG作为标准,采用Spearman相关分析计算aEEG与VEEG识别电发作的相关性.以敏感性、特异性、阳性预测值、阴性预测值评估aEEG诊断新生儿惊厥的价值及局限性. 结果 共62例新生儿的脑电图纳入分析.(1)电发作:VEEG发现39例患儿电发作≥1次,其中8例发生癫痫持续状态,31例非癫痫持续状态惊厥.31例非癫痫持续状态惊厥VEEG发现电发作活动累计352次,其中79.3％(279次)以颞中央区为起始放电灶.(2)电发作次数识别敏感性:8例癫痫持续状态,aEEG与VEEG诊断结果一致;VEEG监测到352次非癫痫持续状态电发作,单导aEEG、单导aEEG附加原始EEG和双导aEEG附加原始EEG识别电发作敏感性分别为49.1％(173/352)、54.5％ (192/352)和81.2％ (286/352),各组识别电发作数和VEEG记录的放电灶记录总数均相关(ρ=0.790、0.907和0.953,P均＜0.01).(3)惊厥患儿识别敏感性(≥1次电发作):单导aEEG、单导aEEG附加原始EEG和双导aEEG附加原始EEG识别惊厥患儿的敏感性分别为66.7％ (26/39,95％ CI:0.62～0.81)、74.4％ (29/39,95％CI:0.78～0.96)和89.7％ (35/39,95％CI:0.89～1.00). 结论 结合VEEG,有助于aEEG诊断新生儿惊厥,aEEG添加T3-T4导联及原始EEG可显著提高其对惊厥电发作及惊厥患儿的识别敏感性.     

Evaluation of maternal knowledge level about neonatal jaundice

Objective: To evaluate the knowledge of mothers on neonatal jaundice. Methods: This study was conducted on 161 mothers who had given birth to healthy newborns at Izmir Aegean Gynecology and Obstetrics Hospital between January 2010 and April 2010. A questionnaire was used to assess the mothers’ knowledge on neonatal jaundice. Knowledge was evaluated as “sufficient” or “insufficient” based on responses. Sufficiently informed mothers were compared with insufficiently informed group for the knowledge level about neonatal jaundice. Results: The rate of insufficiently informed mothers was 53.6%. Logistic regression analysis showed that education level and having a previous offspring with jaundice were independent variables affecting the mothers’ knowledge level. Low education level was found to increase the probability of the mothers’ knowledge level to be insufficient by 2.1 folds (OR 2.1, 95% CI 1.3–3.4; p?=?0.003). Being informed beforehand by a previous offspring with jaundice increased the probability of the mothers’ knowledge to be sufficient by twofolds (OR 2, 95% CI 1.1–3.7; p?=?0.03). Conclusion: It is found that the mothers’ knowledge about neonatal jaundice is insufficient. Maternal education level and having a previous offspring with jaundice are major factors affecting the knowledge of the mothers on hyperbilirubinemia.