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Evaluation of regional cerebral oxygen saturation combined with amplitude integrated electroencephalogram in neonates with hypoxic-ischemic encephalopathy |
TAN Ruokun, HOU Zhanghua, CHEN Lijuan, LI Ya |
Department of NICU, Chenzhou NO.1 People's Hospital, Chenzhou 423000, China |
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Abstract Objective To investigate the changes of regional oxygen saturation (rSO2) and amplitude integrated electroencephalogram (aEEG) in neonates with hypoxic-ischemic encephalopathy (HIE) and their prognostic value. Methods Using prospective research, Collect data on HIE patients admitted to the Department of Neonatology and NICU of Chenzhou First People's Hospital from July 2018 to July 2021. Analyze the rSO2 detection and dynamic monitoring of aEEG results at 4 nodes of the pediatric patients at 6h, 12h, 24h, and 72h after birth. Conduct multivariate logistic regression analysis on the rSO2 detected at 4 nodes at 6h, 12h, 24h, and 72h after birth and the aEEG 5 variables dynamically monitored, and area under the diagnostic curve and perform ROC curve analysis. Results A total of 63 neonates with HIEs were included in the experimental group, including 30 mild HIEs (47.6%), 23 moderate HIEs (36.5%), and 10 severe HIEs (15.9%). The rSO2 levels at various time points in the mild to moderate HIE group were lower than those in the normal control group at 6h, 12h after birth, and in the severe HIE group; The rSO2 levels in children with moderate to severe HIE were lower than those in children with mild HIE; The severe HIE group was lower than the moderate HIE group. The area under the curve for rSO2 levels at 6 hours after birth, rSO2 levels at 24 hours after birth, aEEG monitoring, and their combined diagnosis were 0.891, 0.843, 0.705, and 0.950, respectively. At the optimal critical point, the corresponding sensitivity (specificity) were 0.926(0.822), 0.926(0.989), 0.667(0.700), and 0.960(0.925), respectively; The Receiver operating characteristic shows that the area under the curve obtained by the combined application of the three methods is the largest, and the comprehensive evaluation of its diagnostic sensitivity and specificity is better than that of a single monitoring method. Conclusion Under different degrees of HIE, when rSO2 is too low and abnormal brain function occurs, the degree of brain injury may be more severe. The methods of rSO2 at 6 hours after birth, rSO2 at 24 hours after birth, and aEEG play an important role in evaluating the severity of HIE, and the combined evaluation of the three can improve the accuracy of diagnosis.
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Received: 05 April 2023
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Cite this article: |
TAN Ruokun,HOU Zhanghua,CHEN Lijuan等. Evaluation of regional cerebral oxygen saturation combined with amplitude integrated electroencephalogram in neonates with hypoxic-ischemic encephalopathy[J]. HuNan ShiFan DaXue XueBao(YiXueBan), 2023, 20(4): 43-46.
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URL: |
http://yxb.hunnu.edu.cn/EN/ OR http://yxb.hunnu.edu.cn/EN/Y2023/V20/I4/43 |
[1] 王卫平, 孙锟, 常立文. 儿科学 (第9版) [M]. 北京: 人民卫生出版社, 2018: 100-103. [2] Zhou KQ, McDouall A, Drury PP, et al. Treating seizures after hypoxicischemic encephalopathy-current controversies and future directions[J]. Int J Mol Sci, 2021, 22(13): 7121. [3] Bonifacio SL, Hutson S.The term newborn: evaluation for hypoxicischemic encephalopathy[J]. Clin Perinatol, 2021, 48(3): 681-695. [4] Finder M, Boylan GB, Twomey D, et al.Two-year neurodevelopmental outcomes after mild hypoxic ischemic encephalopathy in the era of therapeutic hypothermia[J]. JAMA Pediatr, 2020, 174(1): 48-55. [5] 张磊, 张璐, 唐建平. 振幅整合脑电图在新生儿HIE早期诊治及动态监测的应用价值[J]. 临床医学工程, 2018, 25(7): 2. [6] 接双双, 戴立英. 近红外光谱技术在危重新生儿的应用及研究进展[J]. 中华全科医学, 2022, 19(12): 2106-2109. [7] Hellstrom-Westas L.Atlas of amplitude integrated EEGs in the newborn[M]. Distributed in North and South America by Taylor &Francis, Informa Healthcare, 2008: 65-86. [8] Domínguez-Dieppa F, Cardetti M, Rodríguez S, et al.Hypoxic ischemic encephalopathy in units reporting to the Ibero-American Society of Neonatology Network: prevalence and mortality[J]. MEDICC Rev, 2021, 23(1): 30-34. [9] 车伟坤, 谢淑霞, 李正森, 等. 近红外光谱检测脑血氧饱和度技术对新生儿脑缺氧的早期评估应用[J]. 医学理论与实践, 2019, 23(17): 2702-2703+2698. [10] 于扬, 司振妍, 吕聪聪.3.0T核磁共振磁敏感加权成像在新生儿缺氧缺血性脑病诊断中的价值分析[J]. 中国基层医药, 2019, 26(3): 272-275. [11] 赵新敏. 新生儿缺氧缺血性脑病的产科相关因素分析[J]. 中国实用神经疾病杂志, 2019, 22(20): 2281-2285. |
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