陈健萍　　黎秀银　　袁海超　　黄冬娜　　陈志凤

[摘要] 目的 探討振幅整合脑电图在脑损伤高危新生儿的监测中的安全性及对临床工作的影响。 方法 以2018年6—12月在我院住院并进行床旁振幅整合脑电图（aEEG）检查的脑损伤高危新生儿为研究对象。记录新生儿基本信息、生命体征、检查过程中的不良事件，并评估振幅整合脑电图对临床工作的影响。 结果 共完成148例次振幅整合脑电图监测，患儿胎龄（38.0±2.5）周，出生体重（2960±571）g。监测前、中、后患儿体温、呼吸、心率、血压比较，差异无统计学意义（P>0.05），监测中经皮血氧饱和度较监测前、监测后上升，差异有统计学意义（P<0.05）。电极粘贴期间出现血氧饱和度下降1例次（0.68%，1/148），哭闹3例次（2.03%，3/148），皮肤发红1例次（0.68%，1/148），电极脱落3例次（2.03%，3/148），影响临床操作2例次（1.35%，2/148），监测中经皮中无严重不良事件发生。 结论 对脑损伤高危新生儿进行床旁振幅整合脑电图检查具有良好安全性，对临床工作影响甚小。

[关键词] 振幅整合脑电图;新生儿;不良事件;安全性

[中图分类号] R722.1          [文献标识码] B          [文章编号] 1673-9701（2021）09-0092-04

Monitoring safety of amplitude integrated electroencephalogram in high-risk neonates with brain injury and its impact on clinical work

CHEN Jianping   LI Xiuyin   YUAN Haichao   HUANG Dongna   CHEN Zhifeng

Department of Neonatology， Dongguan People′s Hospital in Guangdong Province， Dongguan   523000， China

[Abstract] Objective To investigate the monitoring safety of amplitude integrated electroencephalogram （EEG） in high-risk neonates with brain injury and its impact on clinical work. Methods The high-risk neonates with brain injury who were hospitalized in our hospital and underwent bedside amplitude integrated electroencephalogram（aEEG） from June to December 2018 were selected as the research objects. The general data， vital signs of neonates and adverse events during the examination were recorded， and the impact of aEEG on clinical work was evaluated. Results A total of 148 cases were monitored by aEEG. The gestational age was （38.0±2.5） weeks， and the birth weight was （2960±571） g. There were no statistically significant differences in body temperature， respiration， heart rate and blood pressure before， during and after the monitoring（P>0.05）. The blood oxygen saturation during monitoring increased more significantly than that before and after monitoring， with statistically significant difference （P<0.05）. During electrode sticking period， there were 1 case-time of blood oxygen saturation decrease （0.68%， 1/148）， 3 case-times of crying （2.03%， 3/148）， 1 case-time of skin redness（0.68%， 1/148）， 3 case-times of electrode shedding（2.03%，3/148）， and 2 case-times of clinical operation impacted （1.35%， 2/148）， and no serious adverse events occurred during monitoring. Conclusion It is safe to carry out bedside aEEG examination for high-risk neonates with brain injury and has little impact on clinical work.

[Key words] Amplitude integrated electroencephalogram; Neonates; Adverse events; Safety

随着新生儿诊疗技术的发展，大大地提高了危重新生儿抢救成功率，但神经系统后遗症发生率未见明显下降。尽早评估神经系统功能，评价远期预后显得尤为重要[1-3]。目前脑损伤高危新生儿神经评估的手段主要有临床表现、影像学、神经电生理学、神经发育评估[4]。脑电图是临床应用最早、最广泛的脑电生理检查方法。振幅整合脑电图是将原始脑电图图形通过整合、改良，生成趋势图，以便医生随时对脑活动的电压进行观察和测量，是一种从长时间脑电中提取时间压缩的振幅信息，是简化的脑电生理监测方法[5]。主要用于新生儿缺氧缺血性脑病早期判断和预后评估，早产儿大脑发育成熟水平的评估和发作性事件的判断等[6]。振幅整合脑电图在新生儿中应用越来越广泛，可作为危重患儿神经系统常规检查项目，极大地提高了脑损伤的识别率，更好地提示预后[7]。尽管……