脑电图在窒息新生儿早期诊断脑损伤的应用研究

Early evaluation of brain injury by electroencephalogram in neonates with asphyxia

摘要:

目的：探讨脑电图（EEG）在窒息新生儿超早期诊断脑损伤的价值。方法：对2003年9月至2005年6月收治住院的49例窒息新生儿生后6 h内进行EEG检查。结果：49例窒息新生儿中，诊断缺氧缺血性脑病（HIE）33例，EEG异常21例，异常率63.3%；单纯窒息16例，EEG仅1例异常，异常率6.3%，中重度HIE患儿EEG异常100%。EEG异常程度与HIE临床分度基本一致，EEG表现为电静息、爆发抑制改变且2周后持续不恢复者预后差。结论：新生儿窒息早期（6 h内）即可出现EEG改变，EEG可早期反映窒息后脑损伤及程度，EEG可作为窒息新生儿超早期诊断脑损伤的重要检查方法，值得推广应用。

Abstract:

OBJECTIVE: To explore the value of electroencephalogram (EEG) in early diagnosis of brain injury in neonates with asphyxia.METHODS: EEG examination was performed in 49 neonates with asphyxia (mild: n=9; severe: n=40) within 6 hrs of their births. Of the 49 asphyxiated neonates, 33 had concurrent HIE, including 20 cases of mild, 9 cases of moderate and 4 cases of severe HIE. RESULTS: Twenty-one (63.6%) out of the 33 patients with HIE showed abnormal EEG, but only one (6.3%) in the asphyxia group without HIE. All of 13 patients with moderate-severe HIE showed abnormal EEG. The degree of EEG abnormality in neonates with HIE was consistent with the clinical grading of HIE. The neonates whose EEG showed electrical silence and burst suppression and the abnormalities were kept unrecoverable for more than 2 weeks had very poor prognosis.CONCLUSIONS: EEG can reflect brain injury caused by neonatal asphyxia and the severity of brain injury. It may be useful for early diagnosis of brain injury following asphyxia in neonates.