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围产期脑重症监护期间的紧急脑电图检查:适应证与结果

[Emergency electroencephalography during perinatal cerebral intensive care: indications and results].

作者信息

Saliba E, Marret S, Chavet-Queru M S, Degiovanni E, Laugier J

机构信息

Inserm 316, hôpital Clocheville, Tours, France.

出版信息

Neurophysiol Clin. 1998 May;28(2):144-53. doi: 10.1016/s0987-7053(98)80025-7.

Abstract

The main contribution of EEG during intensive care in infants with hypoxic-ischemic encephalopathy is i) to help determine whether infants with subtle clinical manifestations present with epileptic seizures, ii) to determine whether paralyzed or heavily sedated infants present with convulsive phenomena, iii) to assess the therapeutical response to anticonvulsants, 4) to contribute, in combination with ultrasound scanning, to diagnostic evaluation of the severity of lesions, and to provide valuable prognostic informations via the analysis of the background activity, as normal EEG is highly predictive of normal outcome, whereas various abnormal EEG features are constantly associated with subsequent major neurological abnormalities or death. These EEG features are readily available from a very early stage and may both precede and be prognostically more sensitive than information obtained from ultrasound. Recording of neonatal electroencephalogram requires awareness of the normal development of electroencephalographic features in the newborn, skilled technicians, and experienced readers of EEG tracings.

摘要

脑电图在缺氧缺血性脑病婴儿重症监护期间的主要作用是

i)帮助确定临床表现不明显的婴儿是否存在癫痫发作;ii)确定瘫痪或深度镇静的婴儿是否存在惊厥现象;iii)评估对抗惊厥药物的治疗反应;4)与超声扫描相结合,有助于对病变严重程度进行诊断评估,并通过分析背景活动提供有价值的预后信息,因为正常脑电图高度预示着良好的预后,而各种异常脑电图特征则常与随后的严重神经异常或死亡相关。这些脑电图特征在很早的阶段就很容易获得,而且可能比超声检查获得的信息出现得更早,在预后方面也更敏感。新生儿脑电图记录需要了解新生儿脑电图特征的正常发育情况、技术熟练的技术人员以及经验丰富的脑电图记录解读人员。

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