目的 分析振幅整合脑电图应用于脑损伤新生儿脑功能监测的效果,为新生儿脑损伤临床治疗提供科学依据。方法 选取2017年2月—2019年1月盐城市妇幼保健院60例足月宫内窘迫新生儿为观察组,选取同期健康足月儿60例为对照组。受检者均采用振幅整合脑电图进行监测。记录两组振幅整合脑电图异常、图形情况、正常睡眠觉醒周期状况、癫痫样放电;比较两组振幅整合脑电图背景活动的宽带与窄带电压值;比较异常振幅整合脑电图图形与影像学间的关系;评估异常振幅整合脑电图患儿神经行为状况及与神经性特异性蛋白间的关系。结果 观察组振幅整合脑电图异常率为8.33%,显著高于对照组的0.0%(χ²=5.217,P=0.022)。观察组正常睡眠觉醒周期发生率为90.0%,明显低于对照组100.0%(χ²=6.316,P=0.011)。对照组未出现癫痫样活动,观察组出现1例。5例振幅整合脑电图异常患儿中,3例头颅B超检查正常,1例MRI检查提示蛛网膜下腔出血;1例出现不连续正常电压伴不正常睡眠觉醒周期,同时伴癫痫样放电;3例患儿神经行为评估落后。观察组NSE、S-100明显高于对照组,且振幅整合脑电图异常者明显高于振幅整合脑电图正常患儿(F=8.751、6.325,P<0.01)。结论 振幅整合脑电图在脑损伤新生儿脑功能监测中具有较高应用价值,其可较好的判断患儿病情,对指导临床诊治具有重要价值。

Objective To analyze the effect of amplitude integrated electroencephalography (EEG) on brain function monitoring in neonates with brain injury,in order to provide scientific evidence for clinical treatment of neonatal brain injury. Methods A total of 60 full-term infants with fetal distress were selected as the observation group from February 2017 to January 2019,and 60 healthy infants in the same period were selected as control group. Subjects were monitored by amplitude-integrated EEG. Amplitude integrated EEG abnormalities,graphs, the normal sleep arousal cycle status and epileptiform activity were recorded in the two groups. The amplitude and narrowband voltage values of the amplitude of the integrated EEG background activity of the two groups were compared. The relationship between abnormal amplitude integrated EEG pattern and imaging was compared;Relationship between the neuronal behavior and neurological specific protein in children with abnormal amplitude integrated EEG were evaluated. Results The abnormal rate of amplitude integrated EEG in the observation group was 8. 33%,significantly higher than that in control group (0. 0%) (χ²=5. 217,P=0. 022). The rate of normal sleep arousal cycle in the observation group was significantly lower than that in the control group (90. 0% vs. 100. 0%,χ²=6. 316,P=0. 011). No epileptiform activity was observed in the control group,but 1 case occurred in the observation group. Of the 5 children with amplitude-enhanced EEG abnormalities,3 had normal head B examination,MRI showed subarachnoid hemorrhage in 1 case,1 had discontinuous normal voltage with abnormal sleep arousal cycle,accompanied by epileptiform activity,and 3 patients with neurobehavioral assessment were lagged behind and the rest were normal. The NSE and S-100 in the observation group were significantly higher than those in control group,and the NSE and S-100 in children with abnormal amplitude-integrated EEG were significantly higher than those in children with normal amplitude-enlarged EEG (F=8. 751,6. 325,P<0. 01). Conclusions Amplitude-integrated EEG has a high value in monitoring of brain function in neonates with brain injury. It can better judge the condition of children and is of great value of guiding clinical diagnosis and treatment.