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脑电图在早产和足月婴儿中的预后价值(作者译)

[Prognostic value of the EEG in pre-term and full-term babies (author's transl)].

作者信息

Haffner B

出版信息

EEG EMG Z Elektroenzephalogr Elektromyogr Verwandte Geb. 1977 Mar;8(1):18-28.

PMID:405197
Abstract

Looking for long-term prognostic value of the neonatal EEG, 545 records from 125 children in the pre-term and full-term period have been checked for special criterias: 1. Periods of electrocerebral inactivity (with usual amplifier gain) 2. Relative amplitude reduction over one of the hemispheres or localized 3. Focal changes 4. Epileptic activity: focal, multifocal and generalized. 5. Unspecific rhythm of alpha- and epsilon-frequency, which can not be classified as epileptic seizure pattern. According to the pronounciation of these criterias the EEG records were classified as severely, medium, severely, moderately abnormal and as normal. Comparison was done with the results of the last control EEG and the last clinical control examination. The principal results are: 1. Children with severe EEG abnormalities have a high mortality rate (about 70%). Long periods of electrocerebral inactivity are more unfavourable quoad vitam than epileptic discharges. 2. Late sequelae as cerebral palsy, psychomotor retardation and epilepsy are to be expected in all children with severe EEG abnormalities remaining alive and in many children with medium severe EEG abnormalities. 3. The rate of normal psychomotor development increases with the decrease of EEG abnormalities. It is important to mention: 1. EEG records in the first hours and days after birth give the best information regarding a long-term prognosis. 2. In children remaining alive and not developing hypsarrhythmia the observation interval must be more than one year for an estimation of probable electroencephalographic and clinical outcome.

摘要

为探寻新生儿脑电图的长期预后价值,对125名早产儿和足月儿的545份记录进行了特殊标准检查:1. 大脑电静止期(采用常规放大器增益);2. 一侧半球相对波幅降低或局限性改变;3. 局灶性改变;4. 癫痫活动:局灶性、多灶性和全身性;5. 无法归类为癫痫发作模式的α和ε频率的非特异性节律。根据这些标准的显著程度,脑电图记录被分为重度、中度、轻度异常以及正常。与最后一次对照脑电图结果和最后一次临床对照检查结果进行了比较。主要结果如下:1. 脑电图严重异常的儿童死亡率很高(约70%)。大脑电静止期较长对生命而言比癫痫放电更不利。2. 所有存活的脑电图严重异常儿童以及许多脑电图中度异常儿童都可能出现脑瘫、精神运动发育迟缓及癫痫等晚期后遗症。3. 精神运动发育正常的比例随脑电图异常程度的降低而增加。需要提及的重要一点是:1. 出生后头几个小时和几天的脑电图记录能提供关于长期预后的最佳信息。2. 对于存活且未出现高度节律失调的儿童,为评估可能的脑电图和临床结果,观察期必须超过一年。

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