摘要
目的探究新生儿重症监护病房内应用闪光视觉诱发电位的作用和有关因素。方法选择周口市中心医院2021年1月至2022年2月期间新生儿重症监护病房内的102例早产儿,将其作为试验组。另选择同时期在本院普通新生儿病房进行治疗的足月新生儿102例作为常规组。试验组患儿高危因素数量≥两种,常规组患儿均不存在引起脑损伤的高危因素。全部患儿在进入医院1~2周后开展闪光视觉诱发电位检查,针对有异常情况者,在出生后3个月以及6个月开展随访。对比两组患儿闪光视觉诱发电位检测结果以及左眼、右眼P100潜伏期侧差;分析试验组闪光视觉诱发电位检测结果和异常结果两组患儿随访情况。结果试验组患儿左眼、右眼P100潜伏期均长于常规组,波幅均低于常规组,差异有统计学意义(P<0.05)。在102例试验组患儿中,出现P100潜伏期异常表现的共有14例24眼(13.73%),主要为主波缺失,有11例(10.78%)属于双侧缺失,分别是7例高胆红素血症以及4例窒息合并肺出血;有3例(2.94%)属于单侧缺失,主要为甲状腺功能减退。41例64眼(40.20%)延长潜伏期或是增大侧差(超过15 ms),共有88眼出现异常,异常率是43.14%(88/204)。试验组患儿不同胎龄间对比,胎龄在30~34周的患儿闪光视觉诱发电位检测异常率高于胎龄在35~36周的患儿,差异有统计学意义(P<0.05)。针对两组患儿均依次在3个月、6个月时开展随访,试验组患儿中,55例88眼(53.92%)早产儿闪光视觉诱发电位异常者中,有28例(27.45%)患儿恢复正常,3例(2.94%)无变化,依旧存在主波P100缺失情况,24例(23.53%)失访。在常规组患儿内,闪光视觉诱发电位14例21眼(13.73%)异常者,六个月随访后,P100潜伏期全部达到同龄儿童的参考水平,进一步说明患儿病情同胎龄存在差异性。常规组患儿闪光视觉诱发电位左眼、右眼P100潜伏期侧差低于试验组,差异有统计学意义(P<0.05)。结论早产儿开展闪光视觉诱发电位检查能够准确、灵敏的检测视功能状态,具有良好的重复性,窒息以及高胆红素血症等则会增加早产儿发生脑损伤的风险性,另外,患儿病情同胎龄之间也存在一定的差异性。
Objective:To explore the clinical application and relevant factors of flash visual evoked potentials in the neonatal intensive care unit.Methods:102 premature infants in the neonatal intensive care unit of Zhoukou Central Hospital from January 2021 to February 2022 were selected as the experimental group;over the same time,102 full-term infants in our general neonatal ward were set as the routine group.The number of high-risk factors in the experimental group was≥two,and there were no highrisk factors causing brain injury in the routine group.Upon one week to two weeks of admission,the flash visual evoked potentials were performed.The abnormal neonates were followed after 3 months and 6 months of delivery.The results of flash visual evoked potential and the lateral difference of P100 latency in left and right eyes were compared between the two groups;The results of flash visual evoked potential and abnormal results in the experimental group were analyzed.Results:P100 incubation of the left eye and right eye in the test group was longer than in the routine group;the amplitude was lower than in the routine group(P<0.05).Among 102 children in the experimental group,there were 14 cases(24 eyes)with abnormal P100 latency(13.73%),mainly the loss of the main wave,and 11 cases(10.78%)were bilateral loss,including 7 cases of hyperbilirubinemia and 4 cases of asphyxia with pulmonary hemorrhage;Three cases(2.94%)were unilateral deletions,mainly hypothyroidism.In 41 cases,64 eyes(40.20%)extended the incubation period or increased the lateral deviation(more than 15 ms),a total of 88 eyes were abnormal,and the abnormal rate was 43.14%(88/204).41 cases had the extended incubation or increased differences(>15ms)(64 eyes,40.20%);a total of 88 abnormal eyes were have occurred(43.14%,88/204).In the test group,the flash visual evoked potential abnormality rates in infants aged 30-34 gestational weeks were higher than in infants aged 35-36 gestational weeks(P<0.05);infants were followed for 3 months and 6 months.In the test group,55 infants had the abnormal flash visual evoked potentials(88 eyes,53.92%),including 28 recovery cases(27.45%),3 unchanged cases with P100 loss(2.94%)and 24loss of follow-up visit cases(23.53%).In the routine group,21 eyes(13.73%)of 14 patients with abnormal flash visual evoked potential reached the reference level of children of the same age after a six-month follow-up,which further showed that there were differences in the condition of children with the same gestational age.The P100 incubation difference of the left and right eye in the routine group was lower than test group(P<0.05).Conclusion:Flash visual evoked potential examination in premature infants can accurately and sensitively detect the state of visual function,with good repeatability.Asphyxia and hyperbilirubinemia will increase the risk of brain injury in premature infants.In addition,there are certain differences between the condition of children and gestational age.
作者
王娜
卢秀丽
WANG Na;LU Xiuli(Neonatal intensive care,Zhoukou Downtown Hospital,Zhoukou Henan 466000,China)
出处
《临床研究》
2022年第9期66-69,共4页
Clinical Research
