Clinical Application Of Amplitude Integrated Electroencephalogram In Diagnosis And Treatment Of Neonatal Purulent Meningitis

Objectives:Explore the clinical application of aEEG from the diagnosis to treatment of neonatal purulent meningitis(NPM).Methods:Select children diagnosed of NPM for retrospective analysis,they all come from Kunming Children’s Hospital,limited from January 2018 to December 2019.Take them in aEEG abnormal group and aEEG non-abnormal group,on the basis of whether the aEEG is abnormal;and take the aEEG abnormal part in mildly or severely abnormal group.Analyze aEEG from abnormal rate,characteristics and the correlation with clinical manifestations、illness degree and prob the predictive value.Results:1.There are 304 children with NPM,and a total of 148 cases conform to the inclusion standard,including 49 cases in the aEEG abnormal group and 99 cases in the aEEG non-abnormal group;There is no statistical difference in the amniotic fluid,birth weight,and clinic date(P>0.05).2.All children with NPM in this group received aEEG,there are 49 patients(33.11%)in abnormal aEEG group,abnormal aEEG mainly manifested as sleep-wake cycle(SWC),abnormal background activity and abnormal discharge.There are 9 cases in severely abnormal group,accounting for 18.4%of the abnormal group,manifested as abnormal discharge and continuous low voltage(CLV).3.There are 38 cases of obstinacy NPM in this group,26 cases of aEEG abnormal group,the abnormal rate is 68.4%.The aEEG mainly manifeste as delayed SWC,abnormal discharge,and CLV.In the abnormal aEEG group,9 patients(34.6%)had severe abnormality.4.Clinical data and auxiliary examinations were collected for all children.Compared with the aEEG abnormal group and the aEEG non-abnormal group,there are no significant differences in leukocyte abnormalities,increased CRP,and positive blood cultures,all P>0.05;In cranial MRI(column connection number C=0.410),classification is refractory NPM(C=0.404),CSF white blood cells>500×106/L(C=0.327),CSF protein>3g/l(C=0.315),Positive CSF culture(C=0.315),CSF sugar<1.5mmol/l(C=0.312),CSF+blood culture positive(C=0.214),seizures(C=0.209),the difference is significant(P<0.05).5.There are 40 patients in aEEG mildly abnormal group and 9 patients of severe abnormality group;compared the two groups,the leukocyte abnormality,increased CRP,CSF white blood cell>500 ×106/L,CSF sugar<1.5mmol/l,CSF culture positive,blood culture positive,CSF+blood culture positive,cranial MRI,all P<0.05;at the refractory NPM(C=0.407),CSF protein>3g/l(C=0.557),seizures(C=0.415),P<0.05.6.Children are followed up to 15 months,119(80.4%)cases were successfully followed up.3 patients die and 11 cases have psychomotor retardation,Compared these groups,P<0.05,and the Spearman coefficient r is 0.315.Conclusions:1.The abnormal rate of aEEG in NPM is 33.11%,mainly manifested as delayed SWC,abnormal background activity and unusual discharge.The abnormal rate of aEEG in refractory NPM is 68.4%.2.Abnormal aEEG in the early stage of NPM indicates that NPM is serious,and the possibility of turning into refractory NPM or poor prognosis is high.3.aEEG combin other examinations can assist early diagnosis,evaluation the condition,and prognosis of NPM.