脑电图对新生儿缺氧缺血性脑病预后的诊断评估

目的　对缺氧缺血性脑病 ( HIE)患儿进行随访观察 ,以评价脑电图 ( EEG)在判断 HIE预后中的价值。　方法　对 62例 HIE中存活的 57例患儿进行体格检查及智力测试 ,对异常者行CT、EEG检查 ,评价其临床后遗症与新生儿期 EEG的关系。　结果　 62例 HIE患儿新生儿期 EEG显示电静息 3例 ,2例死亡 ,1例偏瘫 ;爆发抑制 4例 ,2例死亡 ,1例脑瘫 ,1例未见明显异常 ;低电压 5例 ,1例死亡 ,1例脑瘫 ,1例 IQ低下 ,2例未见异常 ;9例节律性放电者 ,1例出现癫。EEG重度异常后遗症发生率为 2 9% ,轻度异常其发生率为 3 %。　结论　EEG异常情况与临床 HIE程度呈正相关 ,且重度异常者其后遗症发生率显著高于轻度异常者。新生儿 EEG可作为 HIE早期判断预后的一种有效、方便的检查手段。

Prognostic Value of Electroencephalogram in Newborn with Hypoxic Ischemic Encephalopathy

Objective To evaluate prognostic value of electroencephalogram (EEG) in neonatal with hypoxic ischemic encephalopathy (HIE). Methods Sixty two infants with HIE was studied by doing physical examination, intelligence test, CT and EEG. Their clinical outcome was compared to their EEG in the first month after birth. Results Incidence of sequelae in normal or mild abnormal EEG and severe abnormal EEG were 3%, 29%, respectively. Among three infants of EEG cases, two dead and one developed cerebral palsy infant. Among four of burst suppression found in the EEGs, two cases dead, one developed cerebral palsy, one was normal. In five of hypoactive EEG, one dead, one developed cerebral palsy, and the other was with low IQ. Conlusion The prognosis is related to the background activity of EEG. The presence of a burst suppression EEG pattern and a hypoactive/flat EEG are negative prognostic criteria.