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[早产儿的脑电图检查结果]

[Electroencephalographic findings in preterm neonates].

作者信息

Rico-Fernández Eduardo, Fraire-Martínez María Inés, Gutiérrez-Palomares María Luisa, Núñez-Enríquez Juan Carlos, Rico-Fernández María de la Paz

机构信息

Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Pediatría "Dr. Silvestre Frenk Freund", Departamento de Neurofisiología Clínica. Ciudad de México, México.

Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Pediatría "Dr. Silvestre Frenk Freund", División de Investigación en Salud. Ciudad de México, México.

出版信息

Rev Med Inst Mex Seguro Soc. 2023 Sep 4;61(5):603-609. doi: 10.5281/zenodo.8316443.

Abstract

BACKGROUND

The electroencephalogram (EEG) in the newborn period is highly superior to the clinical exam in the detection and prognosis of brain dysfunctions, since it allows continuous functional documentation of the brain at the patient's bedside in a non-invasive way. However, there is still some disagreement about these findings.

OBJECTIVE

To describe the electroencephalographic findings in newborns with a history of prematurity.

MATERIAL AND METHODS

Cross-sectional, descriptive, retrospective study. The inclusion criteria were: newborns with a history of prematurity, regardless of gender, who underwent an EEG from June 2017 to June 2021. Patients with incomplete electroencephalographic records or clinical records without complete data were excluded; patients using sedatives (thiopental, fentanyl, midazolam, diazepam) were eliminated from the study.

RESULTS

107 patients (37 women and 70 men) with a history of prematurity were included, with a mean gestational age at birth of 30.9 WOG ± 3.25. Electroencephalographic findings were normal in 40%, abnormal in 32%, and immature in 28%. The most frequent abnormal finding was focal paroxysmal activity in 86%. 93.4% of the participants presented comorbidities, the most frequent being neurological.

CONCLUSION

Preterm neonates are at high risk of neurologic sequelae, and EEG is a sensitive method for assessing neuromotor and cognitive prognosis. In our study population, one-third had abnormal findings. Early postnatal screening is helpful, but additional records are usually needed to detect high-risk newborns. It would be important to continue studying this line of research in pediatrics.

摘要

背景

新生儿期的脑电图(EEG)在脑功能障碍的检测和预后评估方面比临床检查具有显著优势,因为它能够以非侵入性方式在患者床边对大脑进行连续的功能记录。然而,关于这些发现仍存在一些分歧。

目的

描述有早产史新生儿的脑电图表现。

材料与方法

横断面、描述性、回顾性研究。纳入标准为:2017年6月至2021年6月期间接受脑电图检查的有早产史的新生儿,不限性别。排除脑电图记录不完整或临床记录数据不全的患者;使用镇静剂(硫喷妥钠、芬太尼、咪达唑仑、地西泮)的患者被排除在研究之外。

结果

纳入107例有早产史的患者(37例女性和70例男性),出生时平均胎龄为30.9周±3.25周。脑电图结果正常的占40%,异常的占32%,不成熟的占28%。最常见的异常表现是局灶性阵发性活动,占86%。93.4%的参与者患有合并症,最常见的是神经系统疾病。

结论

早产儿有发生神经后遗症的高风险,脑电图是评估神经运动和认知预后的敏感方法。在我们的研究人群中,三分之一有异常表现。出生后早期筛查有帮助,但通常需要额外的记录来检测高危新生儿。继续在儿科开展这方面的研究很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b748/10599772/b4a7f5847aab/04435117-61-5-603-c001.jpg

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