本文選題：早產(chǎn)兒　切入點：腦功能　出處：《山東大學》2013年碩士論文

【摘要】：第一部分正常早產(chǎn)兒早期振幅整合腦電圖特點的分析 目的探討早產(chǎn)兒早期振幅整合腦電圖(aEEG)背景波的活動特點,為早產(chǎn)兒腦成熟度的判斷提供一定的參考價值。 方法胎齡為25～36+6周的早產(chǎn)兒160例為研究組,按胎齡分為28周組,28～30+6周組,31～33+6周組,34～36+6周組四個組；無顱腦疾病的足月新生兒40例為對照組。應用Olympic CFM6000在兩組新生兒生后72h內進行腦功能監(jiān)測。分析的指標包括電壓的連續(xù)性、睡眠周期、波譜帶下界振幅值及寬度、一個睡眠周期的時程。將早產(chǎn)兒不同胎齡組的結果進行對比分析,并分別與對照組結果進行對比分析,比較不同胎齡早產(chǎn)兒aEEG背景波活動的特點。 結果研究組隨胎齡增加,其aEEG背景波中連續(xù)性電壓所占的比例逐漸增大(P0.01),而對照組均呈連續(xù)性圖形,研究組與對照組間差異有統(tǒng)計學意義(P0.01)；研究組周期出現(xiàn)率逐漸增加(P0.01),對照組均出現(xiàn)成熟的周期變化,研究組與對照組間差異有統(tǒng)計學意義(P0.05)；波譜帶下界振幅有升高趨勢：早產(chǎn)兒各GA組間比較,下界振幅值在AS期組間差異有統(tǒng)計學意義(JP0.01)；帶寬趨于變窄：早產(chǎn)兒各GA組間比較,差異有統(tǒng)計學意義(P0.01)；一個睡眠周期的時程趨于變短,早產(chǎn)兒各GA組間比較,差異有統(tǒng)計學意義(P0.01)；早產(chǎn)兒各GA組相關值分別與對照組比較,差異有統(tǒng)計學意義(P0.05)。 結論胎齡越大的早產(chǎn)兒,其aEEG背景波越趨于成熟,說明aEEG能夠很好的反映早產(chǎn)兒的腦成熟度,能夠很好地應用于臨床早產(chǎn)兒腦功能的監(jiān)測。 第二部分腦損傷早產(chǎn)兒振幅整合腦電圖特點的分析 目的探討腦損傷早產(chǎn)兒早期振幅整合腦電圖(aEEG)背景波的活動特點,明確振幅整合腦電圖對早產(chǎn)兒腦損傷早期診斷的價值。 方法GA28+5～36+6周的55例腦損傷早產(chǎn)兒作為研究組,GA28+1～36+6周的155例正常早產(chǎn)兒作為對照組,應用Olympic CFM6000在兩組新生兒生后72h內進行腦功能監(jiān)測。分析的指標包括電壓的連續(xù)性、睡眠周期、aEEG背景波異常程度。將研究組與對照組結果進行比較,分析腦損傷早產(chǎn)兒aEEG背景活動特點及aEEG對于早產(chǎn)兒腦損傷的早期診斷價值。 結果研究組中,18例(32.7%)背景波形中表現(xiàn)為連續(xù)的背景圖形,37例(67.3%)為不連續(xù)背景,對照組中105例(67.7%)背景波表現(xiàn)為連續(xù)規(guī)則的波形,50例(32.3%)表現(xiàn)為不連續(xù)圖形,研究組與對照組比較,差異有統(tǒng)計學意義(P0.01)；研究組中,23例(41.8%)出現(xiàn)睡眠周期變化,32例(58.2%)未有肉眼可見的睡眠周期變化,對照組中106例(68.4%)有成熟的睡眠周期變化,僅有54例(31.6%)未表現(xiàn)出明顯的睡眠周期的變化,研究組與對照組比較,差異有統(tǒng)計學意義(P0.01)；研究組中aEEG結果的異常分度為：正常aEEG10例(18.2%),異常的45例(81.8%),對照組aEEG結果的異常分度為：正常109例(70.3%),異常46例(29.7%),研究組與對照組比較,差異有統(tǒng)計學意義(P0.01)。 結論腦損傷早產(chǎn)兒的aEEG的特點為：背景中不連續(xù)電壓所占比例較大,大部分早產(chǎn)兒aEEG背景中無明顯的睡眠周期出現(xiàn)；腦損傷早產(chǎn)兒aEEG的異常率較正常早產(chǎn)兒明顯增加,說明可以應用aEEG(?)(?)早產(chǎn)兒進行早期腦功能監(jiān)測,及時檢出早產(chǎn)兒腦損傷。 第三部分兩種腦電監(jiān)測對早期評價早產(chǎn)兒腦損傷的價值研究 目的探討兩種腦電監(jiān)測方法對早產(chǎn)兒腦損傷的診斷價值。 方法GA28+5～36+6周的55例腦損傷早產(chǎn)兒作為研究組,GA28+1～36+6周的155例正常早產(chǎn)兒作為對照組,應用Olympic CFM6000和上海諾誠NT9W216型16導腦電圖儀分別在兩組新生兒生后72h內進行腦功能監(jiān)測,分別分析腦損傷早產(chǎn)兒兩種腦電監(jiān)測結果的異常程度。將兩種監(jiān)測結果的異常率及各自的靈敏度和特異度進行比較,分析兩種監(jiān)測方法檢出早產(chǎn)兒腦損傷的價值。 結果55例腦損傷患兒aEEG中,10例正常,45例異常,EEG14例正常,41例異常,兩種檢查方法的異常率比較,差異無統(tǒng)計學意義(P0.05)；aEEG的靈敏度為81.8%,EEG的靈敏度為74.5%,差異無統(tǒng)計學意義(P0.05)；aEEG的特異度為70.3%,EEG的特異度為71.0%,差異無統(tǒng)計學意義(P0.05)。 結論aEEG和傳統(tǒng)EEG都是早期檢測早產(chǎn)兒腦損傷的良好工具,兩者的靈敏度和特異度無明顯差異,兩者各有利弊,可以根據(jù)具體情況選擇監(jiān)測方法。
[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.
緇撴灉鐮旂┒緇勪腑,18渚，

本文編號：1696813