动态脑功能监测和NBNA评分对妊娠期糖尿病母亲新生儿脑发育的评估价值
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摘要
目的:研究动态脑功能检测(aEEG)和新生儿神经行为测定(NBNA)评分对妊娠期糖尿病(GDM)母亲新生儿脑发育的评估价值。方法:选取在我院进行分娩的GDM母亲新生儿240例,按照新生儿出生体重分为大于胎龄儿(LGA)组、适于胎龄儿(AGA)组和小于胎龄儿(SGA)组,对三组新生儿均进行aEEG监测和NBNA评分。比较三组新生儿的aEEG异常发生率,记录三组新生儿NBNA评分及异常比例,分析aEEG监测和NBNA评分对新生儿脑发育的诊断一致性。结果:LGA组、AGA组和SGA组aEEG异常发生率差异有统计学意义(P<0.05),其中LGA组aEEG异常发生率显著高于AGA组(P<0.05),SGA组aEEG异常发生率显著高于AGA组(P<0.05)。LGA组、AGA组和SGA组NBNA总分之间比较,差异有统计学意义(P<0.05)。三组在行为能力、一般反应、主动肌张力和原始反射评分中差异有统计学意义(P<0.05),在被动肌张力的评分中,差异无统计学意义(P>0.05)。三组之间NBNA评分异常率经比较,差异有统计学意义(P<0.05)。aEEG异常和NBNA评分异常具有一致性(χ~2=0.298,P>0.05)。结论:针对GDM母亲新生儿,LGA和SGA发生脑功能损伤的风险较大,在临床中应予以重视,同时aEEG监测和NBNA评分均为GDM母亲新生儿脑发育诊断的重要方法,针对两项检测均异常的高危患儿,应及时进行临床干预,以改善预后。
Objective:To study aEEG monitoring and NBNA score in the application of dynamic brain function monitoring on neonates with gestational diabetes mellitus mother.Methods:A total of 240 neonates of GDM mothers were selected according to the birth weight of the newborn,which were divided into the greater than gestational age(LGA)group,the suitable for gestational age(AGA)group and the small for gestational age(SGA)group.aEEG monitoring and NBNA scores were performed in all three groups of newborns.The incidence of aEEG abnormalities in the three groups of neonates was compared.The NBNA scores and abnormal proportions of the three groups were recorded.The consistency of aEEG monitoring and NBNA scores in the diagnosis of neonatal brain development was analyzed.Results:The incidence of aEEG abnormalities in LGA group,AGA group and SGA group was significantly different(P<0.05).The incidence of aEEG abnormalities in LGA group was significantly higher than that in AGA group(P<0.05).The incidence of aEEG abnormalities in SGA group was significantly higher than that in AGA group(P<0.05).There was a significant difference in the total scores of NBNA between LGA group,AGA group and SGA group(P<0.05).There were significant differences in behavioral ability,general response,active muscle tone and original reflex scores among the three groups(P<0.05).There was no significant difference in the scores of passive muscle tone(P>0.05).The abnormal rate of NBNA scores between the three groups was compared,and the difference was significant(P<0.05).aEEG abnormalities and NBNA score abnormalities were consistent(χ2=0.298,P>0.05).Conclusion:For GDM mothers neonates,LGA and SGA have a high probability of brain damage,which should be paid attention to in clinical practice.aEEG monitoring and NBNA score are important methods for the diagnosis of neonatal brain development in GDM mothers neonates.High-risk children should be promptly clinically intervened to improve prognosis.
Objective:To study aEEG monitoring and NBNA score in the application of dynamic brain function monitoring on neonates with gestational diabetes mellitus mother.Methods:A total of 240 neonates of GDM mothers were selected according to the birth weight of the newborn,which were divided into the greater than gestational age(LGA)group,the suitable for gestational age(AGA)group and the small for gestational age(SGA)group.aEEG monitoring and NBNA scores were performed in all three groups of newborns.The incidence of aEEG abnormalities in the three groups of neonates was compared.The NBNA scores and abnormal proportions of the three groups were recorded.The consistency of aEEG monitoring and NBNA scores in the diagnosis of neonatal brain development was analyzed.Results:The incidence of aEEG abnormalities in LGA group,AGA group and SGA group was significantly different(P<0.05).The incidence of aEEG abnormalities in LGA group was significantly higher than that in AGA group(P<0.05).The incidence of aEEG abnormalities in SGA group was significantly higher than that in AGA group(P<0.05).There was a significant difference in the total scores of NBNA between LGA group,AGA group and SGA group(P<0.05).There were significant differences in behavioral ability,general response,active muscle tone and original reflex scores among the three groups(P<0.05).There was no significant difference in the scores of passive muscle tone(P>0.05).The abnormal rate of NBNA scores between the three groups was compared,and the difference was significant(P<0.05).aEEG abnormalities and NBNA score abnormalities were consistent(χ2=0.298,P>0.05).Conclusion:For GDM mothers neonates,LGA and SGA have a high probability of brain damage,which should be paid attention to in clinical practice.aEEG monitoring and NBNA score are important methods for the diagnosis of neonatal brain development in GDM mothers neonates.High-risk children should be promptly clinically intervened to improve prognosis.
引文
[1]杨晓燕,任楠楠,张文香.妊娠糖尿病发病率及其相关危险因素分析[J].陕西医学杂志,2018,47(5):577-579.
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[10]李敏许,彭倩,尹映仪.脑电图在评估新生儿缺氧缺血性脑病远期预后中的价值[J].广东医学,2011,32(3):348-350.
[11]王萍,余文发.脑电图在新生儿缺氧缺血性脑病早期诊断和预后评估中的意义[J].中国实用神经疾病杂志,2016,19(1):66-67.
[12]侯爱华.脑电图在新生儿缺氧缺血性脑病早期诊断和预后评估中的价值探讨[J].中国继续医学教育,2017,9(5):90-91.
[13]李佳,侯新琳.应用振幅整合脑电图评价妊娠期糖尿病对新生儿脑发育的影响[J].发育医学电子杂志,2016,4(4):218-222.
[14]吴丽萍,王朝霞,施文平,等.单胎足月新生儿行为神经测评影响因素分析[J].中国计划生育和妇产科,2014(2):39-43.
[15]高树辉,陈小强,林秀雯,等.糖尿病对新生儿神经行为发育的影响[J].中国妇幼保健,2015,30(14):2198-2200.
[2]米阳,王艳霞,郭娜,等.妊娠期糖尿病患者妊娠结局临床分析[J].陕西医学杂志,2015,44(9):1211-1213.
[3]辛琳琳,杨红玉,陈金华,等.脑电图评价新生儿脑损伤程度的临床应用[J].吉林医药学院学报,2013,34(2):101-103.
[4]谢幸,苟文丽.妇产科学[M].8版.北京:人民卫生出版社,2014:77.
[5]姚烨,洪金玲,陈琪,等.妊娠期高血压对新生儿脑损伤及脑发育影响的研究[J].中华医学超声杂志:电子版,2015(4):44-48.
[6]姜百灵,张方芳.妊娠期糖尿病患者血糖水平与新生儿出生体重关系分析[J].中国医学创新,2014(2):61-62.
[7]姬静璐.妊娠期糖尿病孕妇对新生儿体重及神经系统发育影响分析[J].中国妇幼保健,2015,30(19):3208-3210.
[8]蒋新液,卫雅蓉,陈雅芬.妊娠期糖尿病对子代影响的研究进展[J].中国儿童保健杂志,2013,21(7):723-725.
[9]王孝君,谭先凤,王光友,等.妊娠期糖尿病对新生儿神经行为发育的影响[J].中国实用神经疾病杂志,2014,17(8):59-60.
[10]李敏许,彭倩,尹映仪.脑电图在评估新生儿缺氧缺血性脑病远期预后中的价值[J].广东医学,2011,32(3):348-350.
[11]王萍,余文发.脑电图在新生儿缺氧缺血性脑病早期诊断和预后评估中的意义[J].中国实用神经疾病杂志,2016,19(1):66-67.
[12]侯爱华.脑电图在新生儿缺氧缺血性脑病早期诊断和预后评估中的价值探讨[J].中国继续医学教育,2017,9(5):90-91.
[13]李佳,侯新琳.应用振幅整合脑电图评价妊娠期糖尿病对新生儿脑发育的影响[J].发育医学电子杂志,2016,4(4):218-222.
[14]吴丽萍,王朝霞,施文平,等.单胎足月新生儿行为神经测评影响因素分析[J].中国计划生育和妇产科,2014(2):39-43.
[15]高树辉,陈小强,林秀雯,等.糖尿病对新生儿神经行为发育的影响[J].中国妇幼保健,2015,30(14):2198-2200.
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