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目的探讨新生儿HIE恢复期振幅整合脑电图(aEEG)背景活动特点。方法选择2009年3月-2010年12月在本院NICU住院的46例胎龄37~41周的HIE恢复期新生儿为研究组,另选28例在新生儿病区住院的非颅脑疾病的足月新生儿作为对照组,对2组新生儿进行脑功能监测,获取aEEG,对aEEG背景活动的连续性、睡眠-觉醒周期(SWC)、最高电压以及最低电压等4个指标进行比较。结果 HIE患儿恢复期脑电背景中,有30例为不连续性脑电图,而对照组新生儿均为连续性脑电图,2组比较差异有统计学意义(χ2=30.71,P<0.05);HIE患儿恢复期脑电背景中,仅9例具备成熟的SWC,而对照组新生儿均具备成熟的SWC,2组比较差异有统计学意义(χ2=45.04,P<0.05);HIE组最高电压为(56.53±19.34)μV,对照组最高电压为(37.78±2.77)μV,2组比较差异有统计学意义(t=5.09,P<0.05),且HIE组最高电压变异较大;HIE组最低电压为(4.27±1.24)μV,对照组最低电压为(7.74±0.68)μV,2组比较差异有统计学意义(t=-13.62,P<0.05)。结论 HIE恢复期患儿脑电活动表现为不连续性脑电图,不具备SWC,最高电压较正常升高,而最低电压低下。通过对HIE患儿进行aEEG检查,分析aEEG的连续性、SWC、最高电压及最低电压,可为患儿预后判断提供临床依据。
Objective To investigate the background characteristics of amplitude-integrated electroencephalography (aEEG) in neonatal HIE during convalescence. Methods From March 2009 to December 2010, 46 neonates with HIE convalescent gestational age of 37 to 41 weeks in NICU hospital were enrolled in this study, and 28 non-craniocerebral diseases hospitalized in neonatal ward Of full-term newborns were used as control group. Brain function was monitored in two groups of newborns and aEEG was obtained. The aEEG background activity continuity, sleep-wake cycle (SWC), maximum voltage and minimum voltage were compared. Results In the recovery period of HIE children, there were 30 cases of discontinuous electroencephalogram (EEG) in the convalescent phase of EEG, while those of control group were all continuous electroencephalogram. There was significant difference between the two groups (χ2 = 30.71, P < 0.05). Only 9 cases had mature SWC in the recovery phase of EEG, while the control group had mature SWC. The difference between the two groups was statistically significant (χ2 = 45.04, P <0.05). The maximum voltage in HIE group was (56.53 ± 19.34) μV, and that in control group was (37.78 ± 2.77) μV, there was significant difference between the two groups (t = 5.09, P <0.05) (4.27 ± 1.24) μV in the HIE group and 7.74 ± 0.68 μV in the control group (t = -13.62, P <0.05). Conclusions The EEG activity in convalescent HIE patients is discontinuous EEG without SWC. The highest voltage is higher than the normal while the lowest voltage is lower. By aEEG examination of children with HIE, analysis of aEEG continuity, SWC, the maximum voltage and minimum voltage, can provide a clinical basis for the prognosis of children.