Romeo M G, Tina L G, Cilauro S, Morano C, Virzì G, Rodonò A, Betta P, Saporito A, Distefano G
Clinica Pediatrica II, Università di Catania, Italia.
Pediatr Med Chir. 1998 May-Jun;20(3):197-9.
Cerebral function monitor (CFM), unlike traditional EEG, allows a long-term evaluation of electric brain activity, without interfering with the nursing of the newborn in the intensive care unit. Our aim was to evaluate the prognostic value of CFM for neurological outcome. We studied 102 newborns (gestational age 34.5 +/- 4.36 weeks; weight 1980 +/- 720 grams) by Multitrace CFM (Lectromed) 5 hours daily in the first week following admission. The patients also underwent cerebral echography, EEG and neurological follow-up to the 24th month. CFM was found to correlate well with the EEG recorded 3 months later. The persistence for at least one week of an I.C. tracing or the normalization of initial tracing have a good prognostic value (positive predictive value 95.23%), a persistently pathologic registration has a negative prognostic value (negative predictive value 85.18%), that even increases if cerebral echographic alterations are demonstrated (98.57%). The association of CFM and ultrasound abnormalities determines a relative risk for neurological motor impairment of 69.14, whereas CFM alone gives a relative risk of 6.4.
与传统脑电图不同,脑功能监测仪(CFM)能够对脑电活动进行长期评估,且不会干扰重症监护病房中新生儿的护理工作。我们的目的是评估CFM对神经学转归的预后价值。我们对102例新生儿(胎龄34.5±4.36周;体重1980±720克)进行了研究,在入院后的第一周每天使用多通道CFM(Lectromed)监测5小时。这些患儿还接受了脑超声检查、脑电图检查以及至24个月的神经学随访。结果发现CFM与3个月后记录的脑电图有很好的相关性。脑功能监测仪(CFM)至少持续一周的颅内描记或初始描记正常化具有良好的预后价值(阳性预测值95.23%),持续的病理性记录具有不良预后价值(阴性预测值85.18%),如果同时存在脑超声改变,该不良预后价值甚至会增加(98.57%)。CFM与超声异常同时出现时,神经运动功能障碍的相对风险为69.14,而仅CFM异常时相对风险为6.4。