新生儿胆红素脑病急性期脑功能监测VIP免费

生堡』L型苤圭!Q!!生!旦筮!!鲞筮!塑垦!也』旦!ii坐：丛!翌!!!!!：y!!：!!：盟!：!新生儿胆红素脑病急性期脑功能监测罗芳林慧佳鲍毓陈正马晓路施丽萍杜立中·221·．临床研究与实践．【摘要】目的探讨振幅整合脑电图(aEEG)在新生JLN红素脑病急性期的变化以及在其临床诊断、分期以及预后的评估价值。方法对2009年10月至2011年12月，在我院新生儿重症监护病房住院的10例急性胆红素脑病患儿进行以aEEG为主要内容的模块化神经电生理体系的多项脑功能指标监测，将脑功能监测结果与急性胆红素脑病临床分期、脑干诱发电位(BAEP)、头颅MRI表现以及临床随访结果进行比较。结果aEEG波形识别：连续正常电压5例；不连续电压4例；BS+1例；癫痴性活动记录到8例，单次惊厥2例，反复惊厥2例，癫痫持续状态4例；睡眠觉醒周期(SWC)：2例成熟；5例不成熟；3例无。aEEG波形异常程度判定：正常0；轻度异常者3例；重度异常7例。8例进行BAEP检查异常程度分级：2例为中度异常、6例为重度异常。6例患儿行头颅MRI检查：l例正常，5例苍白球或小脑齿状核的信号改变。双向有序等级资料相关性分析提示aEEG波形异常程度与急性胆红素脑病的临床分期、BAEP分级均存在相关性。aEEG波形轻度异常3例在纠正年龄6月龄infanib评分正常2例，过渡1例；7例aEEG波形重度异常的患儿中死亡1例，失访1例，异常3例(痉挛性四肢运动障碍2例，张力低下1例)，过渡2例。结论以aEEG为主要内容的模块化神经电生理体系的多项脑功能指标监测可以用于胆红素脑病急性期的脑功能监测，并与临床分期、BAEP异常分级存在相关性；对临床预后亦有一定的评估价值，有待于增加临床病例进一步证实。【关键词】脑电描记术；高胆红素血症；脑疾病，代谢性；婴儿，新生：胆红素脑病Amplitude-integratedelectroencephalographicchangesinneonateswithacutebilirubinencephalopathyLUoFnng，HNHuijia，BAOYu，CHENZheng，MAXiao—lu，sHILi-ping，DULi—zhong．Children7SHospitalofZhejiangUniversitySchoolofMedicine，Hangzhou310003，ChinaCorrespondingauthor：SHILi-ping(Email：s加in92008@yahoo．cn)【Abstract】objectiveTocharacterizeamplitude—integratedelectroencephalographic(aEEG)tracesinneonateswithacutebilirubinencephalopathy(ABE)，explorethevalueofaEEGinearlydiagnosisandpredictionofneurologicaloutcomeofABE．MethodaEEGrecordsof10caseswithABE(Oct2009．Nov20ll1werereviewedtoidentifyneonateswithadiagnosisofABE．Clinicaldatawerecollected．TheaEEGtraceswereclassifiedaccordingIobackgroundactivity(normal。moderate。orseverelyabnormal)．presenceofseizuresandsleep．wakecycling(SWC)．Brainstemauditoryevokedpotential(BAEP)andmagneticresonanceimaging(MRI)werestudied．TheneuromotordevelopmentofsurvivorswithABEwasassessedbyusingtheInfantNeurologicalInternationalBattery(INFANlB)．ResultThecharacteristicsofaEEGtracingsintheseinfantswithABEwereshowncontinuousnormalvoltage(CNV．n=5)．discontinuousvoltage(DNV，n=4)，discontinuousvoltagewithburst·suppression(BS)BS+(n=1)；matureSWC(n=2)，immatureSWC(昆=5)，noSWC(忍=3)；8infants(80％)hadelectricalseizures：singleseizure(n=2)；repetitiveseizures(n=2)，andstatusepilepticus(SE)(n=4)．Amongthe10infantswithABE，noinfantshadnormalaEEG，3hadmildlyabnormalaEEG，and7hadseverelyabnormalaEEG．EightinfantsacceptedBAEPtest．2weremildlyabnormaIand6wereseverelyabnornlal．SixinfantsacceptedMRI．1wasnormaland5wereabnormal．Bychi．squareanalysisandSpearmanrankcorrelationanalysis．theresultsofaEEGclassificationwerecorrelatedwiththephaseofABEandtheseverityofBAEP．Theseinfantswerefollowedupformorethan6months(range6monthstolyear)．In3infantswithmildlyabnormalaEEG．2werenormaland1wastransitininfanibscoreat6monthsofage．Of7infantswithseverelyabnormalaEEG．1died，3wereabnormal(2Spasticd...