霍光研+++张晓雪++战艳++王玉平++赵绚　朱小颖　+李婷　+李瑞

[摘要] 目的 探討不同皮肤护理干预措施对预防儿童行视频脑电监测引起头皮损伤的效果。 方法 选取2015年1月～2016年6月于首都医科大学宣武医院儿科行视频脑电监测的250例患儿为研究对象，采用随机数字表法分为棉球组、3M水胶体敷料组、3M硅胶胶布组、康惠尔水胶体敷料组和对照组，每组各50例，分别采用棉球、3M液体敷料、3M硅胶胶布、康惠尔水胶体敷料进行脑电头皮保护，对照组按照病房常规视频脑电监测的固定方法进行视频脑电监测的电极固定。脑电结束后进行头皮损伤评估，并进行组间比较。 结果 五组患儿头皮损伤程度差异有高度统计学意义（P < 0.01）；两两比较显示，棉球组、3M硅胶胶布组与对照组比较，头皮损伤差异有统计学意义（P < 0.01或P < 0.05）。 结论 使用棉球和3M硅胶胶布对视频脑电患儿进行头皮保护可以降低患儿视频脑电引起的头皮损伤的严重程度，为临床实践提供借鉴。

[关键词] 视频脑电监测；头皮损伤；皮肤护理；儿童

[中图分类号] R473 [文献标识码] A [文章编号] 1673-7210（2017）09（b）-0068-04

Clinical study of different skin care interventions for prevention of scalp injury induced by video electroencephalogram in children

HUO Guangyan1 ZHANG Xiaoxue2 ZHAN Yan1 WANG Yuping3 ZHAO Xuan1 ZHU Xiaoying1 LI Ting1 LI Rui1

1.Department of Pediatrics， Xuanwu Hospital， Capital Medical University， Beijing 100053， China； 2.Nursing School，Capital Medical University， Beijing 100069， China； 3.Department of Neurology， Xuanwu Hospital， Capital Medical University， Beijing 100053， China

[Abstract] Objective To explore the effect of different skin care interventions for prevention of scalp injury induced by video electroencephalogram （VEEG） in children. Methods From January 2015 to June 2016， 250 cases of children provided with VEEG in Pediatrics Department of Xuanwu Hospital， Capital Medical University were selected， and randomly divided into the medical cotton ball group， 3M hydrocolloid dressings group， 3M silicone adhesive group， Comfeel hydrocolloid dressing group and control group， each group had 50 cases. Patients were given corresponding treatments of medical cotton ball， 3M hydrocolloid dressings， 3M silicone adhesive and Comfeel hydrocolloid dressing for scalp protection during VEEG， while patients in the control group were given the convention electrode fixed method during VEEG. The severity of scalp injury was compared among these groups. Results There was statistically significant difference in severity of scalp injury among the five groups （P < 0.01）； pairwise comparison results showed that the differences in severity of scalp injury between the medical cotton ball group， 3M silicone adhesive group and the control group had statistically significant （P < 0.01 or P < 0.05）. Conclusion The application of medical cotton ball and 3M silicone adhesive can reduce the severity of scalp injury induced by VEEG in children， which provides reference for clinical practice.

[Key words] Video electroencephalogram； Scalp injury； Skin care； Childrenendprint

癫痫是以反复癫痫发作为临床特征的慢性脑部疾病。癫痫患病率仅次于脑卒中，近几年随着生活方式的改变以及生活压力的增加，发病率有显著升高趋势[1]。儿童是癫痫的高发时期，尤其是学龄前期和婴幼儿期，频繁的发作对患儿的身体、心理及家庭都带来很大的伤害[2]。一直以来癫痫的诊断以病史为主，近年来随着影像学技术的不断发展，脑电图逐渐成为儿童癫痫诊断和治疗效果评估的重要手段[3]。视频脑电图（video-VEEG）是在常规脑电图的基础上加上录像技术[4]，是目前癫痫诊断和分型中最有价值的检测方法[5]，也是小儿神经科用于癫痫诊断的关键方法。视频脑电监测实现了患儿脑电图变化和临床表现的同步分析，有助于醫生判断异常波形与患儿临床表现的关系[6]。……