摘要
目的通过对高胆红素血症患儿进行振幅整合脑电图(a EEG)检测并与正常非高胆红素血症足月新生儿进行比较,明确a EEG是否能早期发现高胆红素血症的脑损伤,通过及时有效的治疗方法,减少胆红素脑病的发病率、病死率及后遗症发生率。方法选择2018年1月-2019年6月该院新生儿科收治的240例高胆红素血症足月新生儿作为观察组,另选择同期该院产科240例健康足月新生儿作为对照组。两组新生儿均接受a EEG检测、脑干听觉诱发电位(BAEP)检测及其他相应检查。分析比较两组a EEG异常发生率和BAEP阳性率的差别。结果两组新生儿高胆红素血症发生率比较,差异无统计学意义(P>0.05)。两组新生儿每日经皮胆红素平均值比较,观察组均高于对照组,但差异无统计学意义(P>0.05)。观察组患儿a EEG异常率显著高于对照组,差异有统计学意义(P<0.05)。观察组患儿BAEP阳性率显著高于对照组,差异有统计学意义(P<0.05);观察组患儿a EEG异常程度越高,BAEP阳性率越高,a EEG异常程度与BAEP阳性率呈显著正相关(P<0.05)。随访1年,1例a EEG重度异常患儿失访。166例a EEG轻度异常患儿中,有28例轻度异常(16.87%),无一例后遗症发生;a EEG重度异常者7例,仍全部异常(100.00%),其中3例轻度异常,4例仍重度异常,2例存在不同程度的后遗症。结论a EEG其灵敏度和特异度较BAEP高,可作为诊断胆红素脑病的敏感指标,利于胆红素脑病的早期诊断,便于及时治疗。可有效预警胆红素脑病的发生,从而减少不可逆性胆红素脑损伤。
Objective To determine whether a EEG monitoring can detect early neuronal damage in children with hyperbilirubinemia,with timely and effective treatment,to reduce the incidence rate,mortality and reduce sequelae of ABE.Methods Choose 240 full-term neonates with hyperbilirubinemia who were admitted to our hospital from January of 2018 to June of 2019 were selected as observation group,240 healthy full-term newborns were selected as control group.a EEG,BAEP and other examinations were performed in both groups.The difference of a EEG abnormal rate and BAEP positive rate between the two groups was analyzed and compared.Correlation analysis of blood bilirubin level with AEEG abnormal rate and BAEP positive rate in observation group.Follow-up and check a EEG.Results Comparison of the incidence of neonatal hyperbilirubinemia between the two groups,the difference was not statistically significant(P>0.05).Comparison of the average daily transcutaneous bilirubin between the two groups,the observation group was higher than the control group,but the difference was not statistically significant(P>0.05).The abnormal rate of a EEG in the observation group was significantly higher than that in the control group,the difference was statistically significant(P<0.05).The positive rate of BAEP in the observation group was significantly higher than that in the control group,the difference was statistically significant(P<0.05),the higher the abnormal degree of a EEG in the observation group,the higher the positive rate of BAEP,the abnormal degree of AEEG was positively correlated with the positive rate of BAEP(P<0.05).The patients were followed up for 1 year,a case of serious abnormal AEEG lost to follow-up.Among 166 patients with mild abnormal a EEG,28(16.87%)had mild abnormal a EEG,with no sequelae occurred,all of the 7 patients with severe abnormal a EEG were still abnormal(100.00%),there were 3 cases with mild abnormality,there were 4 cases were still severe abnormal,and 2 case with different degrees of sequelae.Conclusion a EEG has higher sensitivity and specificity than BAEP,it can be used as a sensitive index for the diagnosis of bilirubin encephalopathy,it’s helpful for early diagnosis of bilirubin encephalopathy,and is convenient for timely treatment.It can effectively warn the occurrence of bilirubin encephalopathy,to reduce irreversible bilirubin brain image.
作者
韩明
孙智勇
高燕
王书兰
彭峰
王静竹
祝巍
徐健
孙秀红
HAN Ming;SUN Zhi-Yong;GAO Yan(Jilin Province Maternal and Child Health Care Hospital,Changchun,Jilin 130061,China)
出处
《中国妇幼保健》
CAS
2021年第12期2777-2780,共4页
Maternal and Child Health Care of China
基金
吉林省财政厅资助项目(20181)。
关键词
振幅整合脑电图
脑干听力诱发电位
高胆红素血症
新生儿
Amplitude integrated electroencephalogram
Brainstem auditory evoked potential
Hyperbilirubinemia
Neonate
作者简介
通信作者:孙智勇,E-mail:1845576101@qq.com。
