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[重度出生窒息新生儿的新生儿多导睡眠图]

[Neonatal polysomnography in newborn infants with severe birth asphyxia].

作者信息

Hernández-Duarte A M, Domínguez-Dieppa F, Roca-Molina M C

机构信息

Servicio de Neurofisiología Clínica, Hospital Ramón González Coro, Ciudad Habana, Cuba.

出版信息

Rev Neurol. 2007;44(7):392-6.

Abstract

INTRODUCTION

Neonatal polysomnography studies (electroencephalogram, electrooculography, body movements, cardiorespiratory frequencies) were performed in 101 newborn full-term infants diagnosed with severe birth asphyxia.

PATIENTS AND METHODS

To analyse results, the sample was divided into two groups, depending on whether hypoxic-ischaemic encephalopathy (HIE) had occurred or not. The results of the polysomnography studies were correlated with those from the full-term neurological examination and the sequelae from the neurological development during the first two years of life.

RESULTS

Significant correlations were obtained among the variables that were studied. The normality observed in the electrophysiological study in the group of patients with severe asphyxia without HIE was associated with a full-term neurological examination and with a neurological development that has progressed in a satisfactory manner. In the group of patients with grade II HIE there was a predominance of severe alterations in the full-term neonatal polysomnography study, which were significantly correlated with the pathological full-term neurological examinations and serious sequelae from neurological development.

CONCLUSIONS

It has been proved that neonatal polysomnography studies are a valuable aid in evaluating the neurological status of newborn infants in a critical condition and in predicting the sequelae of neurological development in the first two years of life. Further research should be aimed at determining the effects exerted by the daily administration of medication (sedatives, anaesthetics and antiepileptic agents) in critical newborn infants on electrical activity in the brain and the cyclic structuring of the different phases of sleep.

摘要

引言

对101例被诊断为重度出生窒息的足月新生儿进行了新生儿多导睡眠图研究(脑电图、眼电图、身体运动、心肺频率)。

患者与方法

为分析结果,根据是否发生缺氧缺血性脑病(HIE)将样本分为两组。多导睡眠图研究结果与足月神经学检查结果以及生命最初两年神经发育后遗症相关。

结果

在所研究的变量之间获得了显著相关性。在无HIE的重度窒息患者组中,电生理研究中观察到的正常情况与足月神经学检查以及进展良好的神经发育相关。在II级HIE患者组中,足月新生儿多导睡眠图研究中严重异常情况占主导,这些异常与病理足月神经学检查以及神经发育严重后遗症显著相关。

结论

已证明新生儿多导睡眠图研究有助于评估危重新生儿的神经状态,并预测生命最初两年神经发育后遗症。进一步研究应旨在确定危重新生儿每日用药(镇静剂、麻醉剂和抗癫痫药物)对大脑电活动和睡眠不同阶段的周期性结构所产生的影响。

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