- 新生儿连续脑电监测图形快速判读
- 毛健 黄为民
- 1049字
- 2025-02-15 05:01:50
第四章 新生儿不同发育阶段正常脑电图特点
基于新生儿脑发育不成熟及新生儿期脑发育成熟速度非常快的特点,新生儿期EEG具有明显的特征和独立的评价标准。
本章通过图表形式,总结了新生儿期EEG的发育特征,包括新生儿睡眠-觉醒周期特征(图4-1)、新生儿-婴儿期睡眠结构表(表4-1)、睡眠-觉醒周期识别的发育特征(图4-2)、不同发育时期IBI的长度(表4-2)、不同PMA发育成熟度相关的标志性波(表4-3)及新生儿期不同发育时期脑电发育成熟特征(图4-3)。
![](https://epubservercos.yuewen.com/56E00F/21846784401662306/epubprivate/OEBPS/Images/P4-1_112876.jpg?sign=1739655498-OPFJ1L24wqd8LATjWfY5LJzNoPCywLI4-0-31dcd4f5654396875d16128ca066c85d)
图4-1 新生儿睡眠-觉醒周期特征图
表4-1 新生儿-婴儿期睡眠结构表
![](https://epubservercos.yuewen.com/56E00F/21846784401662306/epubprivate/OEBPS/Images/T4-1_33881.jpg?sign=1739655498-y8eTxPIkpFV7MZBfCLhsSLUlkNq8PAhj-0-c13bbff0afb591b8716124426cb9d65c)
![](https://epubservercos.yuewen.com/56E00F/21846784401662306/epubprivate/OEBPS/Images/P4-2_112877.jpg?sign=1739655498-ujoRfjrmM8uwMBR8TCb0JVcXQWvBAqlS-0-1813976669a3d7b45f5c5eec69d5d566)
图4-2 睡眠-觉醒周期识别的发育特征图
表4-2 不同发育时期的IBI长度
![](https://epubservercos.yuewen.com/56E00F/21846784401662306/epubprivate/OEBPS/Images/T4-2_34761.jpg?sign=1739655498-LSRYKPE6XYlBZR9t1oavD2aSFGXZYWga-0-42b175809180ccb3cf1cca7e4e2b117b)
表4-3 不同PMA发育成熟度相关的标志性波
![](https://epubservercos.yuewen.com/56E00F/21846784401662306/epubprivate/OEBPS/Images/T4-3_34777.jpg?sign=1739655498-NLT1sJ4vw66dz7DcerbVZTRJuaRG1FF2-0-d973d4653703e5300004a1441274cb7d)
![](https://epubservercos.yuewen.com/56E00F/21846784401662306/epubprivate/OEBPS/Images/P4-3_35183.jpg?sign=1739655498-PeQMxmtP78r0esX6xjWrg1JRYKnBjIWa-0-9ffccc5abeee33e682e05d0a9e46666d)
图4-3 新生儿期不同发育时期脑电发育成熟特征
QS:安静睡眠期;AS:活动睡眠期
为了帮助读者更好地理解上述发育特征,列举了正常新生儿脑电图的基本特征(图4-4~图4-7)、与发育成熟度相关的标志性波形(图4-8~图4-13)、不同时期正常发育图形(图4-14~图4-25),以及不同发育时期正常aEEG趋势图汇总(图4-26)。
![](https://epubservercos.yuewen.com/56E00F/21846784401662306/epubprivate/OEBPS/Images/P4-4_35591.jpg?sign=1739655498-1Kr6NLvlHtQChK4pye5mCaIvP2OAdMsy-0-2501d4be9f41cfd18f5e3ea8672a153d)
图4-4 GA 36周 +1,DOL 6天,PMA 37周,AS期连续图形
走纸速度15mm/s
![](https://epubservercos.yuewen.com/56E00F/21846784401662306/epubprivate/OEBPS/Images/P4-5_35999.jpg?sign=1739655498-4Jgf5Ho9a7qCJyTLbq9xcLdcLBSmXnLa-0-d26c06b06f87498713ac8acbbbc27b2b)
图4-5 GA 38周 +4,DOL 3天,PMA 39周,QS期交替图形(TA)
走纸速度15mm/s
![](https://epubservercos.yuewen.com/56E00F/21846784401662306/epubprivate/OEBPS/Images/P4-6_36407.jpg?sign=1739655498-egkAgNkpj9BRFTdLJJKZtGvyT1AqSfrx-0-e750b10f7fafc009eb248481dd9591fb)
图4-6 GA 27周 +5,DOL 2天,PMA 28周,QS期非连续图形(TD)
双枕区为心电伪迹,走纸速度15mm/s
![](https://epubservercos.yuewen.com/56E00F/21846784401662306/epubprivate/OEBPS/Images/P4-7_36815.jpg?sign=1739655498-Wig5imXTXrMMR29BFPnYyPX9lXGT18u3-0-937a6639001b7e5ce03f687e26437d71)
图4-7 GA 33周 +5,DOL 4天,PMA 34周 +2,同步性及对称性
走纸速度15mm/s
![](https://epubservercos.yuewen.com/56E00F/21846784401662306/epubprivate/OEBPS/Images/P4-8_37330.jpg?sign=1739655498-rfo2EYnho2Z3TVIKSlrE3FfytzctJ2Zw-0-d316a95439dce09a387f6587e5b7a84d)
图4-8 GA 37周,DOL 9天,PMA 38周 +2,紫色虚框与红色虚框示双侧半球非同步
走纸速度15mm/s
![](https://epubservercos.yuewen.com/56E00F/21846784401662306/epubprivate/OEBPS/Images/P4-9_37753.jpg?sign=1739655498-9r7SH5icyjkb7NS4a2LBtJ5xEltrupVv-0-f85f4687a3c7e6170d15def7177a9679)
图4-9 GA 29周,DOL 7天,PMA 30周,颞区θ暴发(红色虚框)
![](https://epubservercos.yuewen.com/56E00F/21846784401662306/epubprivate/OEBPS/Images/P4-10_38182.jpg?sign=1739655498-mG7716dVN0fzyChfPj4jc4hXzRqwTZhb-0-94b2c65bf32ede9408a82b3147614305)
图4-10 GA 38周 +2,DOL 6天,PMA 39周 +1,前头部非节律性慢波(红色虚框)
![](https://epubservercos.yuewen.com/56E00F/21846784401662306/epubprivate/OEBPS/Images/P4-11_38607.jpg?sign=1739655498-weyrudx4nzI2jIwRt3xQwP8rj5JM6NBK-0-fd6914803f4e430a3d0667183b72e3f5)
图4-11 GA 38周 +2,DOL 6天,PMA 39周 +1,额区一过性尖波(红色虚框)
![](https://epubservercos.yuewen.com/56E00F/21846784401662306/epubprivate/OEBPS/Images/P4-12_112886.jpg?sign=1739655498-yNB5h6jzvYMpZ1Z5nFPMeggkBTeqm7nc-0-ca616a0907726929313fc5838788ee87)
图4-12 GA 28周,DOL 5天,PMA 28周 +5,弥漫性δ活动、δ刷
![](https://epubservercos.yuewen.com/56E00F/21846784401662306/epubprivate/OEBPS/Images/P4-13_39437.jpg?sign=1739655498-1v4nHRltthzZTObrxnjT7WuK115S4uyB-0-098b1aac7efb24b4c6e696ea11c967ed)
图4-13 GA 33周 +5,DOL 8天,PMA 34周 +6,中央、顶、枕区δ刷(红色虚框)
![](https://epubservercos.yuewen.com/56E00F/21846784401662306/epubprivate/OEBPS/Images/P4-14_39858.jpg?sign=1739655498-Uqosu1WXWl6uVbPpCaaEgKnc2h3dgvqY-0-20accb0b31980eada1e24bd710b54119)
图4-14 GA 28周,DOL 5天,PMA 28周 +5,清醒期(红色箭头)
![](https://epubservercos.yuewen.com/56E00F/21846784401662306/epubprivate/OEBPS/Images/P4-15_40271.jpg?sign=1739655498-pljp00wNFYuPCpooO17ASEhEk7m3RngO-0-179e834d4142eb8eecd60a900d9dfbb6)
图4-15 GA 28周,DOL 5天,PMA 28周 +5,AS期(红色箭头)
双枕区为心电伪迹
![](https://epubservercos.yuewen.com/56E00F/21846784401662306/epubprivate/OEBPS/Images/P4-16_40680.jpg?sign=1739655498-riIkyCHqXIbhgR3TYvm92ZCKV6yYdeet-0-c02292d2de2b6f3053a70a27ce1feac1)
图4-16 GA 28周,DOL 5天,PMA 28周 +5,QS期(红色箭头)
双枕区为心电伪迹,走纸速度15mm/s
续图
![](https://epubservercos.yuewen.com/56E00F/21846784401662306/epubprivate/OEBPS/Images/P4-17_41091.jpg?sign=1739655498-Sz0UOfK69WvUxZ1r7PnOrAVFALubYdjI-0-48bb7372d9d42c81e8742b3d52f78461)
图4-17 GA 33周 +5,DOL 4天,PMA 34周 +2,清醒期(红色箭头)
![](https://epubservercos.yuewen.com/56E00F/21846784401662306/epubprivate/OEBPS/Images/P4-18_41502.jpg?sign=1739655498-JPm6mv6BHrZLLymQjwZaMJDJkpbuvaUW-0-096746320a915a00de8e815a9c086e9d)
图4-18 GA 33周 +5,DOL 4天,PMA 34周 +2,AS期(红色箭头)
![](https://epubservercos.yuewen.com/56E00F/21846784401662306/epubprivate/OEBPS/Images/P4-19_41913.jpg?sign=1739655498-huUezoYUndX1p3AHZgydvk9dt4DIsnce-0-269bc8416fdbef9fcaaca34eb509c965)
图4-19 GA 33周 +5,DOL 4天,PMA 34周 +2,QS期(红色箭头)
![](https://epubservercos.yuewen.com/56E00F/21846784401662306/epubprivate/OEBPS/Images/P4-20_42324.jpg?sign=1739655498-OSVrnkWb7Yssm8KwgmtceeU8YF7yDt7I-0-4e755883f45f9b0afe99cf36395fa4be)
图4-20 GA 36周 +1,DOL 6天,PMA 37周,清醒期(红色箭头)
![](https://epubservercos.yuewen.com/56E00F/21846784401662306/epubprivate/OEBPS/Images/P4-21_42735.jpg?sign=1739655498-yDGrN9hKh4lhXKKJwmX7c8oo2pcN3M3g-0-05a5d53b240e838b4b8b9f89c6a85502)
图4-21 GA 36周 +1,DOL 6天,PMA 37周,AS期(红色箭头)
![](https://epubservercos.yuewen.com/56E00F/21846784401662306/epubprivate/OEBPS/Images/P4-22_43146.jpg?sign=1739655498-jGeZ2WxJZsFQk7tFS5ZYr4p6VgzmYxSw-0-e34366c76302befc67dc39eefdda6667)
图4-22 GA 36周 +1,DOL 6天,PMA37周,QS期(红色箭头)
走纸速度15mm/s
![](https://epubservercos.yuewen.com/56E00F/21846784401662306/epubprivate/OEBPS/Images/P4-23_43557.jpg?sign=1739655498-f02aGVoPXwf0a4Ub4x9X7i4CBY2nIxlD-0-1f62643fc3760c48573b9e2998370558)
图4-23 GA 39周 +2,DOL 5天,PMA 40周,清醒期(红色箭头)
![](https://epubservercos.yuewen.com/56E00F/21846784401662306/epubprivate/OEBPS/Images/P4-24_43968.jpg?sign=1739655498-42NBIMAwWEQd7xkrhtkDA36qXClQOs7g-0-9bca900770beb58048092bca4e4edbd7)
图4-24 GA 39周 +2,DOL 5天,PMA 40天,AS期(红色箭头)
![](https://epubservercos.yuewen.com/56E00F/21846784401662306/epubprivate/OEBPS/Images/P4-25_44379.jpg?sign=1739655498-kvI9fOEMspSJaiBgEFciMSsCNum5VzfM-0-8ae8c26e5632e6f62d3537cfa0df6d18)
图4-25 GA 39周 +2,DOL 5天,PMA 40周,QS期(红色箭头)
走纸速度15mm/s
![](https://epubservercos.yuewen.com/56E00F/21846784401662306/epubprivate/OEBPS/Images/P4-26_112891.jpg?sign=1739655498-H9P5qpEXrE6wyoJreOLcLY2UQLv5wYnU-0-20c7fe4f5d4c41e9ad203385bcbc0dd7)
图4-26 不同发育时期正常aEEG趋势图汇总
(田艺丽)