| ObjectiveTo observe the variation of interburst interval duration (IBI) and high-amplitude slow waves in bedside video-electroencephalogram (VEEG) ofpreterm infants between28and30weeks of conceptional age (CA) andexplore the value of that in prognosis and clinical significance.MethodsBedside VEEG were recorded in the fist24to72hours of life for allthe premature infants from28to30weeks CA, who were hospitalized in theneonatal intensive care unit (NICU) between August2011and May2012.According to the CA, patients were divided into two groups (28~29weeksCA and30week CA), and based on the prognosis condition subdivided intosurvival group and death group. A20minutes semi-quantitative analysismethod was made in the IBI and the high-amplitude slow waves. Inaddition，mainly anomaly indexes were analyzed in correlation with thecranial B-ultrasonic results. Results1. Compared with the death group，IBI in the survival group wassignificantly shorter and showed decreasing trend with CA. The mean IBI,the maximum IBI and the percentage of IBI in survival group were4.669s,18.609s and25.47%respectively, which were significantly shorterthan in the death group (P0.001); at28~29weeks CA, the three IBIindexes in the survival and death group were5.009s vs7.081(P<0.05),23.174s vs40.490s (P<0.01) and33.52%vs39.80%(P>0.05) respectively;at30week CA, the three IBI indexes in the two groups were4.426s vs7.559s,15.349s vs30.312s and21.87%vs48.34%respectively, all thedifferences were of notable significance (p<0.01).2. At28~30weeks CA, high-amplitude slow waves of150to300μVare numerous and predominant on the temporal, occipital and frontal areas.The number of high-amplitude slow waves which exceeded300μV on thetemporal and occipital areas and that at30weeks CA on the frontal area werehigher in the death group than in the survival group (P<0.05).3. Both deformed delta brushes and delta waves with superimposedhigh-voltage sharp activity had a higher incidence and more numerous in thedeath group (P<0.05); The incidence of general deformed delta waves andthe number of sharply like delta waves were more than in the survival groupalso (P<0.05).4. Prolonged IBI and the delta waves with superimposed high-voltage sharp activity had a positive association with abnormal cranial ultrasound(P<0.01).Conclusion1. Discontinuous activity decrease with CA in infants between28and30weeks CA. When the mean IBI>7s, maximum IBI>30s and thepercentage of IBI>44%, they may prompt a poor prognosis, in contrast,better prognosis will be gained when they are lower than4.5s,20s and21%;2.The maximum IBI can be considered as pathological when itsduration exceed30s between28and29weeks CA,20s at30weeks CA;3. Recurring high-amplitude slow waves of150~300V in frontal polearea suggest a brain lesion and poor outcome, especially the presence ofslow waves above300μV can provide more clinical significance;4.When the high-amplitude slow waves in temporal, occipital andfrontal pole areas are characterized by deformed delta brushes, sharply likedelta waves and general deformed delta waves, and repeatedly appears, thatneed clinical attention, when characterized by delta waves withsuperimposed high-voltage sharp activity, height indicate brain injury andpoor prognosis;5. Preterm infants between28and30weeks CA have a high incidenceof brain injury and in particular the younger premature, EEG performed inthe early time after birth can provide important evidence for early diagnosis of brain injury and predicting prognosis. |
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