新生儿重症监护病房早产儿视觉诱发电位检查及其相关因素分析

目的探讨闪光视觉诱发电位(flash visual evoked potentials,FVEP)在新生儿重症监护病房的应用及相关因素分析,为早产儿视功能诊断提供科学依据。方法收集新生儿重症监护病房早产儿30例作为实验组,该组患儿常合并两种或多种高危因素,普通新生儿病房足月新生儿30例作为对照组,均排除致脑损伤高危因素的普通病种住院患儿。两组患儿均在入院后1~2周行FVEP检查,对异常者,在生后3个月、6个月进行了随访。结果胎龄与P100潜伏期密切相关,表现为胎龄越小,P100潜伏期越延长,差异有高度统计学意义(P<0.001),而引起P100主波缺失的主要高危因素是高胆红素血症、窒息、甲状腺功能减退。对FVEP异常者随访发现,在16例(26眼)早产儿FVEP异常者中,有8例早产儿恢复正常,1例无改变,7例失访。足月儿组中,FVEP4例(6眼)异常,6个月后随访,P100潜伏期均已恢复同龄参考水平。结论 FVEP检查为早产儿视功能状态提供一种准确、灵敏、重复性好的客观检测方法。高胆红素血症、窒息、甲状腺功能减退等是引起早产儿脑损伤不可忽视的高危因素。

Analysis of the use and relative factors about flash visual evoked potentials in neonatal intensive care unit

Objective To explore the use and relative factors analysis of flash visual evoked potentials(FVEP) in neonatal intensive care unit and provide the scientific basis for the diagnosis of visual function. Methods Thirty premature infants with two or more kinds of serious complications from neonatal intensive care unit were selected as experimental group,and thirty full-term newborns from common neonatal wards were selected as control group.Any case with brain injury was excluded.All infants were evaluated by FVEP 1 to 2 weeks after entering the hospital.All cases with abnormal findings were followed up by 3 months and 6 months after birth. Results Gestational age was closely related to clinical latency.The shorter the gestational age was,the longer was the P100 latency,with significant difference(P＜0.01).The major risk factor of the dominant wave deficiency was related to hyperbilirubinemia,asphyxia,hypothyroidism.In 16 cases(26 eyes) of premature infants with abnormal findings of FVEP,there were 8 premature infants were recovered totally,with no change in 1 case and loss to follow up in 7 cases.In the group of term infants,the latency of P100 was recovered after 6 months in 4 cases (6 eyes) with abnormal FVEP. Conclusions FVEP is an objective methods for visual function state in premature infants with wonderful accuracy,sensitivity and better repeatability.FVEP is helpful to understand the damage of nervous system in preterm infants.Hperbilirubinemia,asphyxia and hypothyroidism are regarded as the highly risk factors of brain injury in preterm infants.