| Objective:By studying the characteristics of amplitude integrated electroencephalog-ram in encephalopathy of prematurity,and analyzing the related high-risk influencing factors of abnormal degree of aEEG monitoring results,the clinical application value of aEEG monitoring technology in the diagnosis of encephalopathy of prematurity was explored.Methods:A total of 103 premature infants born in the obstetrics department of the First Affiliated Hospital of Kunming Medical University from December 2018 to February 2020 and transferred to the pediatric neonatal ward after birth were selected as the research subjects,and were divided into 39 cases of encephalopathy of prematurity and 64 cases of non-encephalopathy of prematurity.All subjects underwent amplitude integrated electroencephalogram monitoring after correcting gestational age up to 34 weeks,using Hellstrom-Westas classification and Burdjalov scoring system to interpret each aEEG image,comparing the differences in aEEG monitoring results between encephalopathy of prematurity group and non-encephalopathy of prematurity group.According to the abnormal degree of aEEG monitoring results,70 premature infants with abnormal aEEG monitoring results were divided into 44 cases of mild abnormal group,12 cases of moderate abnormal group and 14 cases of severe abnormal group.Clinical data of 3 groups were collected,to compare the differences in clinical data of the 3 groups,and analyze the related high-risk influencing factors of abnormal degree of aEEG monitoring results.All data were statistically analyzed using SPSS 24.0 statistical software.Results:1.According to the Hellstrom-Westas classification,the detection rates of continuous normal voltage,discontinuous normal voltage,continuous low voltage,burst-suppression,inactivite or flat trace in the encephalopathy of prematurity group were 17.9%,61.5%,17.9%,2.6%,0.0%,and the detection rates of continuous normal voltage,discontinuous normal voltage,continuous low voltage,burst-suppression,inactivite or flat trace in the non-encephalopathy of prematurity group were 53.1%,31.2%,14.1%,1.6%,0.0%,the difference was statistically significant(P?0.05).2.According to the Hellstrom-Westas classification,the abnormal rate of aEEG in the encephalopathy of prematurity group was 82.05%(32/39),the abnormal rate of aEEG in the non-encephalopathy of prematurity group was 46.88%(30/64),?2?12.514,P?0.001.Taking the cranial imaging examination as the "gold standard",the sensitivity of aEEG to diagnose encephalopathy of prematurity was 82.05%and the specificity was 53.12%.3.Compared with the difference in Burdjalov score of"normal" preterm infants of the same gestational age,the adjusted Cycling score was-2.03± 1.26 points in the encephalopathy of prematurity group,and the adjusted Cycling score was-1.41 ± 1.35 points in the non-encephalopathy of prematurity group,the difference was statistically significant(P<0.05).4.According to the Burdjalov scoring system,the abnormal rate of aEEG in the encephalopathy of prematurity group was 89.74%(35/39),and the abnormal rate of aEEG in the non-encephalopathy of prematurity group was 54.69%(35/64),?2?13.677,P?0.001.Taking the cranial imaging examination as the "gold standard",the sensitivity of aEEG to diagnose encephalopathy of prematurity was 89.74%,and the specificity was 45.31%.5.Combining the Hellstrom-Westas classification and Burdjalov scoring system,the abnormal rate of aEEG in the encephalopathy of prematurity group was 100%(39/39),the abnormal rate of aEEG in the non-encephalopathy of prematurity group was 68.75%(44/64),?2=15.124,P?0.001.Taking head imaging as the "gold standard",aEEG had a sensitivity of 100%and a specificity of 31.25%for the diagnosis of encephalopathy of prematurity.6.Analysis of the related high-risk factors for abnormal degree of aEEG monitoring results:the results of comparative analysis among the three groups suggest that gestational age,birth weight,treatment with citrate caffeine,the degree of intracranial hemorrhage,length of hospitalization,number of discharge diagnoses,weight and correct gestational age of aEEG monitoring,the age of total enteral feeding,weight gain rate were related influencing factors of aEEG monitoring results,and the differences were statistically significant between aEEG mild abnormality group,moderate abnormality group and severe abnormality group(P?0.05).The results of multiple regression analysis of the above-mentioned related factors suggested that the gestational age of B=-0.644,P=0.006,the birth weight of B=-0.577,P=0.001,and the days after total enteral feeding of B=0.476,P=0.013.The correlation coefficient of gestational age and Burdjalov score r=0.430,P?0.001,the correlation coefficient of birth weight and Burdjalov score r=0.405,P=0.001,the correlation coefficient of the days of total enteral feeding and the Burdjalov score r=-0.445,P?0.001.Conclusions:1.Both Hellstrom-Westas classification and Burdjalov scoring system can be used to interpret aEEG monitoring results of premature infants,The combination of the two methods is more clinically valuable for diagnosing encephalopathy of prematurity.2.Premature infants' gestational age,birth weight,and age at the time of total enteral feeding are associated with aEEG abnormalities.It is suggested that in clinical work,enteral feeding should be established as early as possible to ensure the nutrients required for the growth of premature babies and the rate of intrauterine growth,which is conducive to improving the brain function of very preterm infants,and screening of preterm infants with encephalopathy should be strengthened for premature infants with small gestational age and low birth weight,timely detection and early intervention can improve the quality of life of premature infants. |
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