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目的运用多导长程脑电图对足月高胆红素血症新生儿进行监测,研究足月新生儿高胆红素血症的脑电图,分析其对预后判断的价值。方法选取足月新生儿(受孕龄为37~42周),其中42例无高胆红素血症的非神经系统疾病患儿和98例高胆红素血症患儿进行多导长程录像脑电监测,每个患儿于出生后第一周内进行脑电监测,并于出生后15天,出生后第一个月末,出生后第三个月分别进行3次随访,分别进行脑电图检查及生长发育评估。采用多样本比较秩和检验和多样本率的比较对血清总胆红素、脑电图结果以及后遗症发生率进行分析。结果 1)不同血清总胆红素水平等级的患者,其脑电图结果有显著差异;脑电图异常率同血清总胆红素水平的增高程度有一定关系。特别是正常组总胆红素水平与中、重度增高组,轻、中度增高组与重度增高组间脑电图结果差异显著。2)脑电图的结果对判断胆红素血症预后有一定意义,且随着脑电图异常程度的增加,预后愈加不容乐观,特别是重度异常脑电图的高胆红素血症患儿,其后遗症发生率明显高于脑电图正常和轻度异常者。结论新生儿多导长程录像脑电监测结合血清总胆红素水平不仅可反映高胆红素血症患儿脑功能的受损程度,还可作为早期预后判断的一个重要手段,该方法简单、方便、经济,可作为新生儿高胆红素血症所致脑损伤的严重程度和预后评估的常规检查方法之一。
Objective To monitor the newborn infants with full-term hyperbilirubinemia by multi-guided long-range EEG and study the EEG of full-term neonatal hyperbilirubinemia and analyze its value in prognosis. Methods Select full-term newborns (gestational age of 37 to 42 weeks), of which 42 non-hyperbilirubinemia non-neurological diseases and 98 cases of hyperbilirubinemia in children with long-range recording of long-range video Electrical monitoring, each child in the first week after birth for EEG monitoring, and 15 days after birth, the first month after birth, the third month after birth were followed up 3 times, respectively, EEG Inspection and assessment of growth and development. Analysis of total serum bilirubin, electroencephalogram results, and the incidence of sequelae were performed using multiple sample comparison rank-sum tests and multiple sample rates. Results 1) Patients with different levels of serum total bilirubin showed significant differences in EEG results. EEG abnormality was related to the level of serum total bilirubin. Especially the normal group of total bilirubin levels and moderate and severe increased group, mild to moderate increased group and severe increased group EEG results were significantly different. 2) The results of EEG have a certain significance in judging the prognosis of bilirubin, and with the increase of EEG abnormality, the prognosis is not optimistic, especially in patients with severe abnormal EEG hyperbilirubinemia Children, the incidence of sequelae was significantly higher than normal and mild abnormal EEG. Conclusion Long-range recording of neonatal long-range recording EEG combined with serum total bilirubin levels can not only reflect the extent of brain dysfunction in children with hyperbilirubinemia, but also as an important means of early prognosis, the method is simple, Convenient, economical, can be used as neonatal hyperbilirubinemia-induced brain injury severity and prognosis of routine testing methods.