脑电监测对早产儿脑功能的早期评估价值研究

发布时间：2018-04-01 18:50

  本文选题：早产儿　切入点：脑功能　出处：《山东大学》2013年硕士论文

【摘要】：第一部分正常早产儿早期振幅整合脑电图特点的分析 目的探讨早产儿早期振幅整合脑电图(aEEG)背景波的活动特点,为早产儿脑成熟度的判断提供一定的参考价值。 方法胎龄为25～36+6周的早产儿160例为研究组,按胎龄分为28周组,28～30+6周组,31～33+6周组,34～36+6周组四个组；无颅脑疾病的足月新生儿40例为对照组。应用Olympic CFM6000在两组新生儿生后72h内进行脑功能监测。分析的指标包括电压的连续性、睡眠周期、波谱带下界振幅值及宽度、一个睡眠周期的时程。将早产儿不同胎龄组的结果进行对比分析,并分别与对照组结果进行对比分析,比较不同胎龄早产儿aEEG背景波活动的特点。 结果研究组随胎龄增加,其aEEG背景波中连续性电压所占的比例逐渐增大(P0.01),而对照组均呈连续性图形,研究组与对照组间差异有统计学意义(P0.01)；研究组周期出现率逐渐增加(P0.01),对照组均出现成熟的周期变化,研究组与对照组间差异有统计学意义(P0.05)；波谱带下界振幅有升高趋势：早产儿各GA组间比较,下界振幅值在AS期组间差异有统计学意义(JP0.01)；带宽趋于变窄：早产儿各GA组间比较,差异有统计学意义(P0.01)；一个睡眠周期的时程趋于变短,早产儿各GA组间比较,差异有统计学意义(P0.01)；早产儿各GA组相关值分别与对照组比较,差异有统计学意义(P0.05)。 结论胎龄越大的早产儿,其aEEG背景波越趋于成熟,说明aEEG能够很好的反映早产儿的脑成熟度,能够很好地应用于临床早产儿脑功能的监测。 第二部分脑损伤早产儿振幅整合脑电图特点的分析 目的探讨脑损伤早产儿早期振幅整合脑电图(aEEG)背景波的活动特点,明确振幅整合脑电图对早产儿脑损伤早期诊断的价值。 方法GA28+5～36+6周的55例脑损伤早产儿作为研究组,GA28+1～36+6周的155例正常早产儿作为对照组,应用Olympic CFM6000在两组新生儿生后72h内进行脑功能监测。分析的指标包括电压的连续性、睡眠周期、aEEG背景波异常程度。将研究组与对照组结果进行比较,分析脑损伤早产儿aEEG背景活动特点及aEEG对于早产儿脑损伤的早期诊断价值。 结果研究组中,18例(32.7%)背景波形中表现为连续的背景图形,37例(67.3%)为不连续背景,对照组中105例(67.7%)背景波表现为连续规则的波形,50例(32.3%)表现为不连续图形,研究组与对照组比较,差异有统计学意义(P0.01)；研究组中,23例(41.8%)出现睡眠周期变化,32例(58.2%)未有肉眼可见的睡眠周期变化,对照组中106例(68.4%)有成熟的睡眠周期变化,仅有54例(31.6%)未表现出明显的睡眠周期的变化,研究组与对照组比较,差异有统计学意义(P0.01)；研究组中aEEG结果的异常分度为：正常aEEG10例(18.2%),异常的45例(81.8%),对照组aEEG结果的异常分度为：正常109例(70.3%),异常46例(29.7%),研究组与对照组比较,差异有统计学意义(P0.01)。 结论脑损伤早产儿的aEEG的特点为：背景中不连续电压所占比例较大,大部分早产儿aEEG背景中无明显的睡眠周期出现；脑损伤早产儿aEEG的异常率较正常早产儿明显增加,说明可以应用aEEG(?)(?)早产儿进行早期脑功能监测,及时检出早产儿脑损伤。 第三部分两种脑电监测对早期评价早产儿脑损伤的价值研究 目的探讨两种脑电监测方法对早产儿脑损伤的诊断价值。 方法GA28+5～36+6周的55例脑损伤早产儿作为研究组,GA28+1～36+6周的155例正常早产儿作为对照组,应用Olympic CFM6000和上海诺诚NT9W216型16导脑电图仪分别在两组新生儿生后72h内进行脑功能监测,分别分析脑损伤早产儿两种脑电监测结果的异常程度。将两种监测结果的异常率及各自的灵敏度和特异度进行比较,分析两种监测方法检出早产儿脑损伤的价值。 结果55例脑损伤患儿aEEG中,10例正常,45例异常,EEG14例正常,41例异常,两种检查方法的异常率比较,差异无统计学意义(P0.05)；aEEG的灵敏度为81.8%,EEG的灵敏度为74.5%,差异无统计学意义(P0.05)；aEEG的特异度为70.3%,EEG的特异度为71.0%,差异无统计学意义(P0.05)。 结论aEEG和传统EEG都是早期检测早产儿脑损伤的良好工具,两者的灵敏度和特异度无明显差异,两者各有利弊,可以根据具体情况选择监测方法。
[Abstract]:An analysis of the characteristics of early amplitude integrated electroencephalogram in normal preterm infants
Objective to explore the characteristics of early amplitude integrated electroencephalogram (aEEG) Bei Jingbo activity in preterm infants, and to provide a certain reference value for the judgment of brain maturity in premature infants.
Methods the gestational age ranged from 25 to 36+6 weeks premature 160 cases as the study group, patients were divided into 28 week group, 28 week group ~ 30+6, 31 ~ 33+6 ~ 34 weeks group, 36+6 weeks group of four full-term infants without brain disease group; 40 patients in the control group. The application of Olympic CFM6000 in brain the function of monitoring in the two groups after birth 72h. Analysis of indicators including continuity, the voltage of the sleep cycle, with lower amplitude and spectrum width, duration of a sleep cycle. The preterm infants of different gestational age group compared with control group, and were compared with the results of comparative analysis, infant aEEG background wave activity.
Results the study group with the increase of gestational age, the background of aEEG wave in continuous voltage proportion gradually increased (P0.01), while the control group showed a continuous pattern, there were statistically significant differences between the study group and the control group (P0.01); increased cycle research group (P0.01), the control group appeared periodic change of maturity, there were statistically significant differences between the study group and the control group (P0.05); spectrum with lower amplitude increased in preterm infants: comparison of each GA group, lower amplitude values were statistically significant between group differences in stage AS (JP0.01); bandwidth become narrow: comparison of premature GA group, was statistically significant the difference (P0.01); time history of a sleep cycle tends to be shorter, more premature GA group, the difference was statistically significant (P0.01); the GA group premature correlation values were compared with the control group, the difference was statistically significant (P0.05).
Conclusion the aEEG background wave of premature infants with premature gestational age is more mature. It shows that aEEG can well reflect the maturity of premature infants, and can be applied to monitor brain function in premature infants.
Analysis of the characteristics of amplitude integrated electroencephalogram in preterm infants with second parts of brain injury
Objective to explore the characteristics of Bei Jingbo's activity in early preterm infants with brain injury, and to evaluate the value of amplitude integrated electroencephalography (EEG) in the early diagnosis of brain injury in premature infants.
55 cases of brain injury in preterm infants GA28+5 ~ 36+6 weeks as the study group, 155 normal preterm infants GA28+1 ~ 36+6 weeks as the control group, the application of Olympic CFM6000 for brain function monitoring in two groups after birth. 72h analysis indicators include voltage continuity, sleep cycle, abnormal aEEG wave background. The research group compared with the control group results, analysis of the value of early diagnosis of brain injury in preterm infants aEEG background activity and aEEG for brain injury in preterm infants.
缁撴灉鐮旂┒缁勪腑,18渚，

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