正常足月新生儿振幅整合脑电图特点的多中心研究

来源 :中国循证儿科杂志 | 被引量 : 0次 | 上传用户:wl349682847
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目的探讨正常足月新生儿生后3 d内振幅整合脑电图(aEEG)的特点,为新生儿临床脑功能监测提供依据。方法选择各参研医院母婴同室或新生儿室的正常足月新生儿为研究对象,依据胎龄分为37周~、38周~、39周~、40周~和41~42周胎龄组。采用首台国产aEEG仪记录正常足月新生儿生后1、2和3日龄的aEEG,每次记录3 h。采用半对数公式计算电压,分析正常足月新生儿aEEG背景波、电压、睡眠-觉醒周期及其影响因素。结果2008年5月至2009年5月纳入116名正常足月新生儿。①正常足月新生儿aEEG背景波呈现连续性波形。90.5%(105/116名)在生后1日龄出现睡眠-觉醒周期,所有正常足月新生儿在生后2日龄均出现睡眠-觉醒周期;②1个睡眠-觉醒周期的平均持续(69.9±18.7)min,其中宽带平均为(22.0±5.7)min,窄带平均为(47.9±17.1)min;③正常足月新生儿生后1、2和3日龄aEEG背景波最低电压分别为(12.8±3.4)、(12.1±2.0)和(12.5±2.6)μV,最高电压分别为(37.5±11.0)、(38.4±9.4)和(38.6±9.6)μV;④日龄、性别、分娩方式及母亲妊娠并发症对正常足月新生儿aEEG的宽带、窄带电压和时程均无显著影响,37周~胎龄组生后1~3日龄aEEG窄带电压上界较38~42周各胎龄组显著增高(P分别为0.014,0.001和0.000)。结论正常足月新生儿aEEG背景波为连续波形,存在明显的睡眠-觉醒周期;最低电压均>5μV,最高电压均>10μV。37周~胎龄组的正常足月新生儿生后1~3日龄aEEG窄带电压上界较38~42周各胎龄组正常足月新生儿显著增高。正常足月新生儿的aEEG表现不受日龄、性别、分娩方式及母亲妊娠并发症的影响。 Objective To investigate the characteristics of amplitude-integrated electroencephalogram (aEEG) within 3 days after birth of normal term newborn and to provide basis for clinical brain function monitoring in neonates. Methods The normal full-term newborns in maternal and neonatal room or neonatal room in each participating hospital were selected as research objects and divided into 37 weeks, 38 weeks, 39 weeks, 40 weeks and 41-42 weeks gestational age according to gestational age group. The first domestic aEEG instrument was used to record aEEG at 1, 2 and 3 days after birth of normal full-term newborns, recording 3 h each time. The half logarithm formula was used to calculate the voltage, and the aEEG background wave, voltage, sleep-wake cycle and its influential factors in normal term neonates were analyzed. Results From May 2008 to May 2009, 116 normal term newborns were included. ① normal full-term neonatal aEEG background wave showed a continuous wave. 90.5% (105/116) showed sleep-wake cycle at 1 day after birth, all normal full-term neonates showed sleep-wake cycle at 2 days after birth, and ② one sleep-wake cycle averaged at 69.9 ± 18.7) min, the average broadband width was (22.0 ± 5.7) min and the narrowband average was (47.9 ± 17.1) min; (3) The minimum voltages of aEEG background wave at 1, ± (12.1 ± 2.0) and (± 12.5 ± 2.6) μV respectively, and the maximum voltage was (37.5 ± 11.0), (38.4 ± 9.4) and (38.6 ± 9.6) μV respectively. ④Day age, gender, mode of delivery and mother Pregnancy complications had no significant effect on the broadband, narrow-band voltage and duration of aEEG in normal term neonates. The upper limit of aEEG narrow band voltage of 1-3 days after birth in 37 weeks ~ gestational age group was higher than that in 38-42 weeks Significantly increased (P 0.014, 0.001 and 0.000, respectively). Conclusion The aEEG background wave of normal term neonates is continuous waveform with obvious sleep-wake cycle. The lowest voltage is> 5μV and the highest voltage is> 10μV. 37 weeks ~ gestational age group of normal full-term newborns 1 to 3 days after birth, aEEG narrow-band voltage upper bound 38-42 weeks of each gestational age group of normal full-term newborns was significantly higher. The aEEG performance of normal term newborns is independent of age, sex, mode of delivery and pregnancy complications of mothers.
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