Application Of Vedio-electroencephalogram In Voiding Pattern Of Term Newborns With Bilirubin Encephalopathy

BackgroundNeonatal urination is a simple spinal reflex,and the traditional view hold that the brain didn't participated in this activity.But,recently,a large number of researchs have shown that newborns micturition function is controlled by the brain.Bladder dysfunction is a very common clinical disease in children.According to the different etiology,it can divided into non-neurogenic and neurogenic bladder dysfunction.Neurogenic bladder dysfunction is derived from central or peripheral nerve damage,which is always accompany with the symptoms of abnormal micturition,such as bladder overactivity or underactivity,urinary incontinence,bladder outlet obstruction,bladder ureter reflux,recurrent urinary tract infections,even leading to renal failure.However,there is no effective treatment for neurogenic bladder dysfunction until now.The key to prevent neurogenic bladder dysfunction is early detection and intervention.Removing the risk factors in reversible phase of nerve injury to reduce or avoid the occurrence of neurogenic bladder dysfunction.Hyperbilirubinemia is a common disease of neonates,divided into physiological hyperbilirubinemia and pathological hyperbilirubinemia.The incidence of physiological hyperbilirubinemia is about 60%,which of pathological hyperbilirubinemia is about 80%.Bilirubin encephalopathy is easier to happen with infection and hemolysis.Bilirubin went into the central nervous system,causing the nerve cell degeneration of poisoning through the blood brain barrier,and a corresponding clinical and subclinical nervous system symptom.Bilirubin encephalopathy is always with the damage of the nervous system.What's more,it may caused body paralyze or death.The Survivors often left with cerebral palsy,intellectual and motor dysfunction.So far,Whether the brain injury of bilirubinencephalopathy has an impact on neonatal urination is unknown.So,it has a potential value of research in this orientation.Video electroencephalogram(VEEG)developed from dynamic electroencephalogram,combined with the video at the same,which had the advantages of discriminating the pseudo differential and interference,capturing the changes of electroencephalogram in the period of urination.VEEG was greatly improved the accuracy of the diagnosis and had a high positive rate of examination.VEEG was widely used in the research of hypoxic ischemic encelhalopathy and epilepsy,which could directly and objectively reflect the early damage,functional status and pathological changes of he brain.This research try to explore the influence of bilirubin encephalopathy on neonatal urination by the video electroencephalogram(VEEG).At the same time,to explore the value of VEEG on neonatal urination and specify the relationship between bilirubin encephalopathy and neonatal urination.ObjectiveTo explore the influence of bilirubin encephalopathy on the voiding pattern of newborn by Video-electroencephalogram.MethodsA total of 54 newborns with hyperbilirubinemia aged 4 to 15 days at the first clinical college of Xinxiang Medical University were included in this study.28 of them were diagnosised as bilirubin encephalopathy(BE),The other 26 newborns were just with hyperbilirubinemia,without bilirubin encephalopathy.(NBE).All newborn are kept in a neutral temperature insulated box? Recording 4h date of neonatal micturition from 8am to 12 am,including the parameter of Voiding frequency(VF),Voiding volume,(VV),postvoiding residual volume(PVR)by ultrasound detection,and the brain activity of diffetent micturition phase(Pre-5,voiding,post-5).Using SPSS 21.0 statistical software for data processing,using two independent samples t test,data used(`X +S),P < 0.05 for the difference was statistically significant.Result(1)In this study,a total of 280 voids were recorded.There was no statistical difference in the age,weight,gestation,and the composition between the BE group and the NBE group(P >0.05).The VF and PVR of BE is higher than that of NBE group[(3.2±0.6)VS(2.8±0.3)times,(2.2±0.5)VS(1.6±0.4)ml] ],which have a significant difference between the two group(P<0.05).The VV of BE group is lower than that of NBE group[(23.6±5.4)VS(28.6±8.2)ml.There is a difference in VV(P <0.05).(2)the Fp2-C4 lead amplitude of BE group during different urination states is lower than NBE group[(94.0±11.3)vs(106.0±15.0)].There is a significant difference in the VEEG amplitude of the two group(P<0.05).Conclusionbilirubin encephalopathy neonates were with an increased VV and PVR,and a reduced VV and amplitude of the the Fp2-C4 lead,which indicated that the bladder voiding of bilirubin encephalopathy was regulated by Frontal region and cerebral cortex.The video Electroencephalogram has a potential value in exploring the effect of bilirubin encephalopathy on the voiding pattern of newborn.