关键词: 脑损伤, 高危儿, 全身运动, 振幅整合脑电图, 联合检测

Abstract: Objective To explore the value of general movements (GMs) assessment combined with amplitude integrated electroencephalogram (aEEG) monitoring in the early diagnosis of neonatal brain injury. Methods A total of 82 high-risk neonates with brain injury born in Luzhou People's Hospital from August 2016 to January 2018 were enrolled in this study.All children were assessed twice by GMs before full term and 2 months after full term.Another assessment was conducted in 9 to 15 weeks after full-term,and all subjects were monitored for aEEG within 6 hours of birth.The results of GMs and aEEG and the diagnostic value of combined examination were observed. Results Among 82 neonates,3 (3.66%) cases were diagnosed with cerebral palsy by the gold standard,21(25.61%) cases had motor retardation,and 58(70.73%) cases had normal motor development.GMs result showed that 28 cases had abnormalities in torsional movement stage,including 23 cases of monotonic GMs (PR) abnormalities and 5 cases of spasmodic-synchronous GMs (CS) abnormalities.There were 5 cases had abnormalities in restless movement stage,of whom 3 cases were with cerebral palsy.Besides,aEEG test indicated that there were 24 mild abnormalities,6 severe abnormalities and 52 normal cases,with the total abnormality rate of 36.59% (30/82).The sensitivity and negative prediction value of GMs and aEEG for predicting cerebral palsy were both 100.00%,but its positive prediction value was low.Moreover,the sensitivity,specificity,and accuracy of predicting motor retardation separately were all higher than 80%.Additionally,the sensitivity,specificity,positive prediction value,negative prediction value,and diagnostic accuracy of the combination of GMs and aEEG were higher than those of single detection method. Conclusion GMs assessment combined with aEEG monitoring has high clinical predictive value for neonatal brain injury because of high sensitivity,specificity,and accuracy.

Key words: brain damage, high-risk infants, general movements, amplitude integrated electroencephalogram, combined detection