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目的通过诱发电位在胆红素脑病中的应用,达到早期发现、早期诊断、早期进行干预性治疗、减少临床后遗症的发生、提高患儿生存质量。方法选取79例新生儿黄疸患儿为观察组,46例同期因轻度呼吸道和肠道疾病而住院就诊的患儿为对照组。全部患儿均在二次喂奶间隔睡眠或安静清醒中放入隔音电屏蔽室内检测,仪器采用英国牛津产肌电、诱发电位仪,使用银质表面盘状电极,清洁皮肤后安放固定。结果 79例患儿均同时检测脑干听觉诱发电位(BAEP)和闪光视觉诱发电位(FVEP),脑干听比较觉诱发电位:观察组异常27例,正常52例;对照组异常5例,正常41例,两组差异有统计学意义(χ2=8.29,P<0.01);闪光视觉诱发电位:观察组异常13例,正常66例;对照组异常2例,正常44例,两组比较差异有统计学意义(χ2=4.04,P<0.05)。脑干听觉诱发电位和闪光视觉诱发电位观察组对比差异有统计学意义(χ2=6.56,P<0.05)。结论诱发电位能早期发现胆红素脑病的发生,做出定侧、定位、定量的分析,为临床的治疗争取时间,在神经可逆期进行干预性治疗,提高患儿的存活率,减少后遗症的发生,提高患儿的生存质量,具有显著的应用价值。
Objective Through the application of evoked potentials in bilirubin encephalopathy, early detection, early diagnosis, early intervention therapy can be achieved to reduce the occurrence of clinical sequelae and improve children’s quality of life. Methods 79 neonates with jaundice were selected as observation group and 46 children hospitalized for mild respiratory and intestinal diseases in the same period as control group. All children were in the second feeding interval sleep or quiet and awake into the soundproof electric shielding indoor testing equipment used in the United Kingdom Oxford EMG, evoked potentiometer, the use of silver surface plate electrode, clean the skin and then placed fixed. Results All of the 79 children underwent both BAEP and FVEP. Brainstem auditory evoked potentials were observed in 27 children with abnormalities in the observation group (n = 27) and normal controls (n = 52). The control group (n = 5) was normal 41 cases, the difference between the two groups was statistically significant (χ2 = 8.29, P <0.01); flash visual evoked potentials: the observation group of abnormal 13 cases, normal 66 cases; control group 2 cases of abnormal, normal 44 cases, Statistical significance (χ2 = 4.04, P <0.05). There was significant difference between brainstem auditory evoked potentials and flash visual evoked potentials (χ2 = 6.56, P <0.05). Conclusion Evoked potentials can detect the occurrence of bilirubin encephalopathy at early stage, make definite side, location and quantitative analysis, gain time for clinical treatment, and carry out interventional therapy in neurotic reversal period to improve the survival rate of children and reduce sequelae Occur, improve children’s quality of life, has a significant application value.