目的 探讨监测不同胎龄早产儿的床旁视频脑电图(video electroencephalogram, VEEG)对判断早期神经系统发育中的评估价值。方法 选取2016-12至2017-10在医院新生儿重症监护室(neonatal intensive care unit, NICU)住院,出院后在新生儿科和神经中心进行随访的早产儿为研究对象。收集患者基本资料,分别在出生后1周及纠正胎龄(corrected gestational age, CA)40周、44周、52周时各进行1次2～3 h 的VEEG检查;在CA 52周进行Gesell 发育量表评估,取5个能区发育商均值(developmental quotient, DQ)。比较各时期VEEG结果与DQ 结果的相关性,并对出生孕周、出生体重、合并疾病情况、住院天数、家庭抚触护理情况等因素和CA 52周Gesell 发育量表评估进行线性与回归分析。结果 出生后1周、 CA 40周及52周的VEEG与Gesell 发育商(DQ)呈高度相关,差异有统计学意义(P=0.004、0.000、0.017),而其中CA 40周VEEG结果相关系数最高。分析出生孕周、出生体重、疾病分类、住院天数、家庭抚触护理情况等因素对不同胎龄早产儿影响,通过单因素及多因素回归分析,差异无统计学意义。结论 早期进行床旁VEEG 检查,可辅助早期评估早产儿神经系统发育情况,给予高风险患儿早期干预可以降低脑损伤的危害。

Objective To explore the value of video electroencephalogram (VEEG) monitoring of premature infants of different gestational age in early diagnosis of the preterm neonatal nervous system.Methods In this prospective study, data on infants who were hospitalized in the NICU Department of Beijing Children’s Hospital between December 2016 and October 2017 was collected. These patients were followed up in the Department of Neonatology and Neuro-rehabilitation Center after being discharged from the hospital. General information of the patients was collected. VEEG examination was conducted at such time points as 1 week after birth, CA 40 w, CA 44 w, and CA 52 w. During their hospital stay, cranial ultrasound was conducted weekly. Gesell Developmental Scale was used for developmental evaluation of each patient at CA 52 w. DQ value was used. The relevance between VEEG and DQ values, respectively, was analyzed using χ² test. The relevance between birth gestational age, body weight at birth, disease category, length of hospital stay, application status of touching in the family, and DQ values was analyzed using linear regression.Results VEEG examination results at 1 week after birth, CA 40 w, and CA 52 w were highly relevant to Gesell Developmental Scale, especially at CA 40 w, with p values of 0.004, 0.000 and 0.017 respectively. The p value of each factor was greater than 0.05.Conclusions This study suggests that early VEEG examination can help predict premature situation and development of the nervous system for children. Early intervention with high-risk infants will reduce brain injury of premature infants.