Clinical value of amplitude-integrated electroencephalogram dynamic monitoring in neonates with different Apgar score / 中国小儿急救医学

ABSTRACT

ObjectiveTo observe the changes of amplitude-integrated electroencephalogram (aEEG)of neonatal asphyxia with different Apgar scores,and to investigate the diagnostic value of aEEG for hypoxicischemic encephalopathy(HIE) in neonatal asphyxia.MethodsaEEG monitoring were detected on 56 fullterm asphyxia neonates who were hospitalized in our neonatal department from Dec 2010 to Oct 2011.According to 1 minute Apgar score after birth,56 cases were divided into two groupsobservation group in which 36 cases with Apgar score 0～7,and control group in which 20 cases with Apgar score 8～10.aEEG monitoring was done within 6 h,2 d,3 d,7 d of each neonates after birth,and the changes of aEEG were analyzed and the diagnostic value on HIE were evaluated.ResultsAmong 20 cases in the control group,the aEEG results in 6 hours after birth were 17 cases (85％) had normal aEEG results,3 cases( 15％ ) mildly abnormal,nd no one severely abnormal.The aEEG results of patients in observation group(36 cases) were 18 cases(50％ ) had normal aEEG results,13 cases(36.1％ ) mildly abnormal,and 5 cases( 13.9％ ) severely abnormal.The abnormal rate in observation group was significantly higher than that of the control group ( x2=5.3,P＜0.001 ).There were 34 HIE patients in the total 36 cases of observation group,whose aEEG monitoring results in 6 hours after birth were associated with HIE clinical grading( Spearman's rank correlation coefficient was 0.867,P＜0.01 ).Dynamic aEEG monitoring for 56 patients showed that 21 cases had abnormal aEEG in 6 hours after birth,in whom 15 cases(71.4％ ) could returned to normal after 48～72 hours after birth,and there were only 4 case (7.1％ ) still had severely abnormal aEEG results in the seventh day after birth.ConclusionThe aEEG dynamic monitoring for full-term HIE neonates after birth enhances early prediction of HIE.