High-risk infant

高危婴儿
  • 文章类型: Journal Article
    早产儿是脑损伤的高危人群,评估早产儿的神经功能恢复非常重要。因此,本文通过振幅整合脑电图和GMs量表评估了脑损伤高危早产儿的神经功能恢复情况。该研究收集了早产儿的基本信息,并进行了幅度整合的EEG检查和GMs量表评估。振幅集成EEG检查使用多电极阵列将电极附着到早产儿头部的特定区域上,以记录脑电波活动,以实时监测早产儿脑中的电活动,并通过电极接收到的信号进行放大和处理,以获得更详细的EEG数据。GMs量表评估儿童的发育和功能状态,并通过观察他们的运动表现来客观评估神经功能的发育和恢复,语言,认知,和社交互动。通过统计处理对数据进行分析。结果表明,高危婴儿早期脑损伤明显。振幅积分脑电参数对脑损伤有一定的预测价值。脑损伤和非脑损伤的GMs量表评估也存在差异。振幅整合脑电图联合GMs量表对预测脑损伤具有一定价值,可为早产儿脑损伤患儿早期干预提供重要依据,有助于改善其神经发育结局。
    Preterm infants are a high-risk group for brain injury, and it is important to evaluate the neurological recovery of preterm infants. Therefore, this paper evaluates the neurological recovery in preterm infants at high risk of brain injury by amplitude-integrated EEG and GMs scale. The study collected basic information on preterm infants and performed amplitude integrated EEG examination and GMs scale evaluation. Amplitude integrated EEG examination attaches electrodes using multielectrode arrays onto specific areas of the premature head to record brain wave activity to monitor electrical activity in the preterm brain in real time and amplify and process through the signals received by the electrodes to obtain more detailed EEG data. The GMs scale evaluates the developmental and functional status of the child and allows an objective assessment of the development and recovery of neurological function by observing their performance in motor, language, cognition, and social interaction. Analysis of the data by statistical processing. The results showed that early brain injury was evident in high-risk infants. Amplitude integrated EEG parameters can have some predictive value for brain injury. There were also differences in GMs scale assessment between brain injury and non-brain injury. Amplitude integrated EEG combined with GMs scale has certain value in predicting brain injury and can provide an important basis for early intervention in children with preterm brain injury and help to improve their neurodevelopmental outcome.
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  • 文章类型: Journal Article
    背景:全身运动评估(GMA)被推荐用于早期发现脑瘫的风险,但需要训练有素的临床专家。我们的目标是在挪威高危婴儿队列中实施远程GMA的家庭和医院拍摄,以及评估父母在家中拍摄婴儿的经历。
    方法:这项知识转化研究使用了前瞻性队列设计,包括在挪威中部地区卫生局的三个地点进行神经发育随访的参与者。父母在足月后的121-146和151-176周之间收集了两张烦躁的一般动作的家庭电影。在足月后12+1和17+6周之间在医院收集另外的膜。所有拍摄的指导指南都是In-MotionApp标准。视频已传输到远程GMA团队,并根据Prechtl的GMA标准将其分类为“GMA可评分”或“GMA不可评分”。家长使用5点Likert量表回应在线调查,以收集有关他们观点的信息,经验,以及在家拍摄婴儿可能带来的担忧。
    结果:来自95个家庭的一百一十二名婴儿参加了研究。92个(96.8%)家庭传输了177个家庭视频。其中84(92%)在当地医院拍摄了95个视频。所有177个家庭视频都是“GMA可评分”,而95个医院视频中有3个(3,1%)被归类为“GMA不可评分”。由于技术错误,八个家庭没有对调查做出回应,两个家庭没有收到调查。78名(91.7%)受访者同意或强烈同意家庭拍摄很容易,5名(5.9%)受访者认为他们更担心在家拍摄后孩子的发育。几乎80%的受访者同意GMA的视频可以在家中而不是在医院拍摄。
    结论:本研究加强了父母家庭拍摄和远程GMA的临床实施,以在高风险随访计划中早期发现CP。远程GMA的实施有可能促进早期干预,以根据国际建议改善CP儿童的功能。
    背景:ClinicalTrials.govID:NCT04287166注册日期:27/02/2020。
    BACKGROUND: General Movement Assessment (GMA) is recommended for early detection of risk for cerebral palsy but requires trained clinical experts. We aimed to implement home- and hospital-based filming for remote GMA in a Norwegian high-risk infant cohort, as well as evaluating parents\' experiences in filming their infant at home.
    METHODS: This knowledge translational study used a prospective cohort design including participants referred to neurodevelopmental follow-up across three sites in the Central Norway Regional Health Authority. Two home films of the fidgety type of general movements were collected between 12+1-14+6 and 15+1-17+6 weeks after term by parents. An additional film was collected at the hospital between 12+1 and 17+6 weeks after term. The instructional guide for all filming was the In-Motion App standards. Videos were transferred to a remote GMA team and classified as either \"GMA scorable\" or \"GMA not scorable\" based on Prechtl\'s GMA standards. Parents responded to an online survey using a 5-point Likert scale to collect information about their perspectives, experiences, and possible worries by filming their infant at home.
    RESULTS: One-hundred-and-two infants from 95 families participated. Ninety-two (96.8%) families transferred 177 home-based videos. Eighty-four (92%) of these had 95 videos taken in their local hospital. All 177 home-videos were \"GMA scorable\" and three (3,1%) out of 95 hospital-based videos were classified as \"GMA not scorable\". Eight families did not respond to the survey and two families did not receive the survey due to a technical error. Seventy-eight (91.7%) respondents agreed or strongly agreed that it was easy to perform home filming and five (5.9%) agreed that they were more worried about their child`s development after filming at home. Almost 80% of respondents agreed that a video for GMA can be taken at home instead of in hospital.
    CONCLUSIONS: This study strengthens the clinical implementation of home filming by parents and remote GMA for early detection of CP in high-risk follow-up programs. The implementation of remote GMA has the potential to facilitate early intervention to improve function in children with CP in line with international recommendations.
    BACKGROUND: ClinicalTrials.gov ID: NCT04287166 Date of registration: 27/02/2020.
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  • Neurodevelopmental disorders in children have become a significant global public health concern, impacting child health worldwide. In China, the current intervention model for high-risk infants involves early diagnosis and early treatment. However, in recent years, overseas studies have explored novel preventive early intervention strategies for neurodevelopmental disorders in high-risk infants, achieving promising results. This article provides a comprehensive review of the optimal timing, methods, and intervention models of the preventive early intervention strategies for neurodevelopmental disorders in high-risk infants. The aim is to enhance the awareness and knowledge of healthcare professionals regarding preventive early intervention strategies for neurodevelopmental disorders in high-risk infants, facilitate clinical research and application of such interventions in China, and ultimately reduce the incidence of neurodevelopmental disorders in this high-risk population.
    儿童神经发育障碍已成为影响全球儿童健康的重大公共卫生问题。国内目前对高危儿一般采用“早期诊断、早期治疗”的干预模式。近年来,国外开始探讨高危儿神经发育障碍的预防性早期干预新技术,并取得较好效果。该文对高危儿神经发育障碍预防性早期干预的开始时机、方法和干预模式等进行综述,以期提高临床医生对高危儿神经发育障碍预防性早期干预技术的认识水平,促进此干预技术在我国的临床研究与应用,降低高危儿神经发育障碍的发生率。.
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  • 文章类型: Journal Article
    目的:描述在澳大利亚有新生儿CP危险因素的婴儿队列中脑瘫(CP)早期诊断和筛查过程中国际指南的实施情况。
    方法:从维多利亚州的11个地点招募的校正年龄<6个月的具有新生儿危险因素的婴儿的前瞻性队列研究,新南威尔士州,昆士兰,澳大利亚。首先,我们实施了一种多模态知识翻译策略,包括障碍识别,技术集成,特殊利益集团。筛查如下:具有神经影像学临床指征的婴儿接受磁共振成像和/或颅脑超声检查。临床或使用应用程序(婴儿移动)记录了Prechtl一般移动评估(GMA)。使用Hammersmith婴儿神经系统检查(HINE)对GMA视频中缺乏或异常的躁动运动的婴儿进行了进一步评估。2/3评估结果不典型的婴儿符合CP高风险标准。
    结果:在招募的597名婴儿(56%为男性)中,95%(n=565)接受了神经影像学检查,90%(n=537)有可评分的GMA视频(2%不可评分/8%没有视频),和25%(n=149)HINE。总的来说,19%的队列(n=114/597)符合CP高风险标准,57%(340/597)至少有2项正常评估(神经影像学,GMA或HINE),24%(n=143/597)的评估不足。
    结论:使用多模式知识翻译策略,在参与站点实施早期CP筛查。尽管COVID-19大流行影响了招聘率,筛查过程中参与度很高.父母和临床医生参与早期筛查的原因需要进一步的情境化和调查。
    OBJECTIVE: To describe the implementation of the international guidelines for the early diagnosis of cerebral palsy (CP) and engagement in the screening process in an Australian cohort of infants with neonatal risk factors for CP.
    METHODS: Prospective cohort study of infants with neonatal risk factors recruited at <6 months corrected age from 11 sites in the states of Victoria, New South Wales, and Queensland, Australia. First, we implemented a multimodal knowledge translation strategy including barrier identification, technology integration, and special interest groups. Screening was implemented as follows: infants with clinical indications for neuroimaging underwent magnetic resonance imaging and/or cranial ultrasound. The Prechtl General Movements Assessment (GMA) was recorded clinically or using an app (Baby Moves). Infants with absent or abnormal fidgety movements on GMA videos were offered further assessment using the Hammersmith Infant Neurological Examination (HINE). Infants with atypical findings on 2/3 assessments met criteria for high risk of CP.
    RESULTS: Of the 597 infants (56% male) recruited, 95% (n = 565) received neuroimaging, 90% (n = 537) had scorable GMA videos (2% unscorable/8% no video), and 25% (n = 149) HINE. Overall, 19% of the cohort (n = 114/597) met criteria for high risk of CP, 57% (340/597) had at least 2 normal assessments (of neuroimaging, GMA or HINE), and 24% (n = 143/597) had insufficient assessments.
    CONCLUSIONS: Early CP screening was implemented across participating sites using a multimodal knowledge translation strategy. Although the COVID-19 pandemic affected recruitment rates, there was high engagement in the screening process. Reasons for engagement in early screening from parents and clinicians warrant further contextualization and investigation.
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  • 文章类型: Systematic Review
    目的:本系统综述确定了定量评估先天性心脏病(CHD)儿童家庭心理社会适应和结果的工具,并评估了工具心理测量学。
    方法:遵循系统评价和荟萃分析指南的首选报告项目和前瞻性注册方案,电子数据库(CINAHL,Embase,PubMed/MEDLINE,PsycINFO,和SCOPUS)从成立到2021年6月20日,都在搜索以英文发表的同行评审文章,报告关于父母/照顾者心理社会结果的定量数据,兄弟姐妹,或家庭系统。提取了仪器特征和心理计量学,并采用了基于Consensus的健康测量指标选择标准(COSMIN)标准来评估仪器质量。描述性统计和叙事综合用于分析。
    结果:总体而言,报告26个国家107个不同样本的108篇文章被纳入。在这些文章中,40种评估心理功能或痛苦的工具,12评估应对,11评估了生活结构的质量,10评估了父母的压力/照顾者的负担,10评估了家庭功能/影响,10评估压力评估,5评估兄弟姐妹的社会心理结果,和2评估夫妻关系满意度/紧张。将COSMIN标准应用于英语工具的原始工具开发文章/手册的可用数据(n=54),67%的人在内容有效性方面获得了积极的属性证据评级,内部一致性为39%,4%的测试-重测可靠性,响应性(纵向效度)为9%。
    结论:在用于评估CHD儿童家庭的心理社会适应和结果的工具中,研究差异很大。由强大的关键心理测量学指导的仪器选择,增加心理测量报告,关键建议包括开发“工具包”方法和全面的CHD特定家庭工具。
    This systematic review identified instruments quantitatively assessing psychosocial adaptation and outcomes in families of children with congenital heart disease (CHD) and evaluated instrument psychometrics.
    Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and a prospectively registered protocol, electronic databases (CINAHL, Embase, PubMed/MEDLINE, PsycINFO, and SCOPUS) were searched from inception until June 20, 2021 for peer-reviewed articles published in English, reporting quantitative data on psychosocial outcomes among parents/caregivers, siblings, or family system. Instrument characteristics and psychometrics were extracted, and adapted COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria were applied to assess instrument quality. Descriptive statistics and narrative synthesis were used for analysis.
    Overall, 108 articles reporting on 107 distinct samples across 26 countries met inclusion. Across those articles, 40 instruments assessed psychological functioning or distress, 12 assessed coping, 11 assessed quality of life constructs, 10 assessed parenting stress/caregiver burden, 10 assessed family functioning/impact, 10 assessed stress appraisal, 5 assessed sibling psychosocial outcomes, and 2 assessed couple relationship satisfaction/strain. Applying COSMIN criteria to available data on original instrument development articles/manuals for English language instruments (n = 54), 67% scored a positive property evidence rating for content validity, 39% for internal consistency, 4% for test-retest reliability, and 9% for responsiveness (longitudinal validity).
    Studies vary widely in instruments used to assess psychosocial adaptation and outcomes among families of children with CHD. Instrument selection informed by robust key psychometrics, increased psychometric reporting, development of both a \"toolkit\" approach and a comprehensive CHD-specific family instrument are among key recommendations.
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  • 文章类型: Journal Article
    低收入和中等收入国家是全球早产负担最大的国家。在这些资源受限的环境中,对幸存者神经发育结局的理解有限.为了加快进度,当前的优先事项是生成更多高质量的数据;与包括早产婴儿家庭在内的各种当地利益相关者接触,以确定在其背景下对他们有意义的神经发育结果;并发展可持续的,可扩展,高质量的新生儿随访模型,与当地利益相关者共同设计,满足低收入和中等收入国家的独特需求。倡导对于将最佳神经发育视为“优先结果”以及降低死亡率至关重要。
    Low- and middle-income countries account for the greatest burden of preterm birth globally; however, there is limited understanding of neurodevelopmental outcomes of survivors within these resource-constrained settings. To accelerate progress, current priorities are to generate more high-quality data; engage with diverse local stakeholders including families of infants born preterm to identify neurodevelopmental outcomes meaningful to them within their contexts; and develop sustainable, scalable, high-quality models of neonatal follow-up, codesigned with local stakeholders, addressing the unique needs of low- and middle-income countries. Advocacy is critical to recognize optimal neurodevelopment as an \"outcome of priority\" along with the reduction in mortality.
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  • 文章类型: Journal Article
    UNASSIGNED:将家庭纳入婴儿干预计划可能更有效地确保依从性和积极结果。包括提供交流和家庭互动的自然和丰富环境的方法对于高危婴儿的康复很重要。
    UNASSIGNED:比较基于家庭合作方法(FCA)和基于神经发育疗法(NDT)的家庭培训的有效性。
    未经评估:平均年龄为32.60±4.53个月的高危婴儿(n=63)接受了为期12周的早期干预。Prechtl的一般运动(GM)评估,Hammersmith新生儿神经检查(HNNE),Hammersmith婴儿神经检查(HINE),BAYLEY-III婴儿和幼儿发展量表,进行第三次添加(BSID-III)。
    UNASSIGNED:在第3级的HINE评分中发现组间存在显著差异,6th,和第12个月(p≤.028),和第6个月的BSID-III评分(认知,语言,和运动)(p<.001)和第12个月(语言)(p=.031)。NDT组和对照组的第3个月HINE评分和Reflex&Reactions评分有显著差异(p≤.021)。FCA组和NDT组6个月HINE评分(p=.032)和12个月HINE评分(p=.007)与对照组比较差异有统计学意义。FCA组与NDT组(p≤0.002)和对照组(p<.001)在第6个月BSID-III认知方面有显著差异,语言,和运动分数。FCA组和对照组在12个月BSID-III语言评分方面存在显着差异(p=.024)。
    UNASSIGNED:早期理疗干预对高危婴儿有效,FCA方案优于NDT。
    UNASSIGNED: The inclusion of families in intervention programs for infants may be more effective in ensuring adherence and positive outcomes. Approaches that include natural and enriched environments that provide communication and family interaction are important in the rehabilitation of high-risk infants.
    UNASSIGNED: To compare the effectiveness of Family Collaborative Approach (FCA) and Neurodevelopmental Therapy (NDT)-based family training.
    UNASSIGNED: High-risk infants (n = 63) with a mean age of 32.60 ± 4.53 months received early intervention for 12 weeks. Prechtl\'s General movements (GMs) assessment, Hammersmith Neonatal Neurological Examination (HNNE), Hammersmith Infant Neurological Examination (HINE), BAYLEY-III Scales of Infant and Toddler Development, and Third Addition (BSID-III) were performed.
    UNASSIGNED: Significant differences between groups were found in HINE scores at the 3rd, 6th, and 12th months (p ≤ .028), and in BSID-III scores at the 6th month (cognitive, language, and motor) (p < .001) and the 12th month (language) (p = .031). There was significant difference between NDT and control group in 3rd month HINE scores and Reflex&Reactions scores (p ≤ .021). FCA group and NDT group was significantly different from control group in 6th month HINE (p = .032) and 12th month HINE scores (p = .007). FCA group significantly different from NDT group (p ≤ .002) and control group (p < .001) in 6th month BSID-III cognitive, language, and motor scores. There was significant difference between FCA and control group in 12 month BSID-III language scores (p = .024).
    UNASSIGNED: Early physiotherapy interventions were effective in high-risk infants and FCA program was superior to NDT.
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  • 文章类型: Journal Article
    越来越多的证据表明,功能性近红外光谱(fNIRS)可以在我们当前对神经回路组织的理解与发育中的大脑中的皮质活动之间提供重要的桥梁。的确,fNIRS允许通过测量神经血管耦合来研究脑功能,该神经血管耦合将神经活动与随后的脑血流量和血红蛋白氧合水平的变化联系起来。虽然文献为典型的开发提供了大量的fNIRS应用,直到最近,该工具已扩展到神经发育障碍(NDDs)的研究。在过去几年中,有关该主题的科学出版物呈指数级增长,反映了人们对将“fNIRS特征”鉴定为具有高翻译价值的生物标志物以支持早期临床诊断和治疗结果的兴趣。本系统综述的目的是描述fNIRS在NDD中的最新临床应用。特别关注学龄前人口。从这个理由出发,对不同科学数据库中的相关研究进行了系统搜索(Pubmed,Scopus,和WebofScience)产生了13篇发表的文章。在这些研究中,fNIRS适用于自闭症谱系障碍(ASD)患者或发生ASD风险高的婴儿。在选定的研究中使用了静息状态条件下的功能连通性和使用多种实验范式的任务诱发的大脑激活,这表明fNIRS可能被认为是鉴定自闭症领域早期定量生物标志物的一种有前途的方法。
    Accumulating evidence suggests that functional Near-Infrared Spectroscopy (fNIRS) can provide an essential bridge between our current understanding of neural circuit organization and cortical activity in the developing brain. Indeed, fNIRS allows studying brain functions through the measurement of neurovascular coupling that links neural activity to subsequent changes in cerebral blood flow and hemoglobin oxygenation levels. While the literature offers a multitude of fNIRS applications to typical development, only recently this tool has been extended to the study of neurodevelopmental disorders (NDDs). The exponential rise of scientific publications on this topic during the last years reflects the interest to identify a \"fNIRS signature\" as a biomarker of high translational value to support both early clinical diagnosis and treatment outcome. The purpose of this systematic review is to describe the updating clinical applications of fNIRS in NDDs, with a specific focus on preschool population. Starting from this rationale, a systematic search was conducted for relevant studies in different scientific databases (Pubmed, Scopus, and Web of Science) resulting in 13 published articles. In these studies, fNIRS was applied in individuals with Autism Spectrum Disorder (ASD) or infants at high risk of developing ASD. Both functional connectivity in resting-state conditions and task-evoked brain activation using multiple experimental paradigms were used in the selected investigations, suggesting that fNIRS might be considered a promising method for identifying early quantitative biomarkers in the autism field.
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  • 文章类型: Journal Article
    目的:本研究旨在分析“关爱儿童发展”计划对有发育迟缓风险的儿童母亲的敏感性和反应能力的影响。
    方法:本研究是一项准实验研究,具有前测-后测设计以及实验组和对照组。统计人群包括大不里士所有有发育迟缓风险的母亲。通过有目的的抽样选择了50名母亲。然后,采用简单随机抽样方法将其分为两组,每组25例(一个实验组和一个对照组)。实验组接受了“关爱儿童发展”计划的培训,而对照组未接受任何培训。社会情绪评估/评估措施家庭概况(SEAMTM家庭概况)和产妇照顾质量量表是研究测量工具。通过协方差分析(ANCOVA)和使用SPSS软件版本20的独立t检验来评估获得的数据。
    结果:实验组和对照组在产妇护理质量和反应性方面存在显着差异,提供适当的活动,可预测的程序,提供游戏环境和安全家居(P<0.05)。
    结论:结果表明,儿童发展护理计划对有发育迟缓风险的儿童母亲的敏感性和反应能力具有积极影响,可以作为一项切实可行的计划考虑和应用在国家卫生政策中。
    OBJECTIVE: The present study was done to analyze the impact of the \"care for child development\" program on the sensitivity and responsiveness skills among mothers of children at risk of developmental delay.
    METHODS: This study was a quasi-experimental research with a pretest-posttest design and experimental and control groups. The statistical population included all mothers with children at risk of developmental delay in Tabriz. Fifty mothers were selected through purposive sampling. Then, they were divided into two groups of 25 cases (one experimental group and one control group) using simple random sampling. The experimental group received training about the \"care for child development\" program, while the control group received no training. The Social-Emotional Assessment/Evaluation Measure Family Profile (SEAM TM family profile) and Maternal Caregiving Quality Scale were the research measurement tools. The obtained data were evaluated by analysis of covariance (ANCOVA) and independent t-test using SPSS software version 20.
    RESULTS: There was a significant difference between the experimental and control groups in maternal caregiving quality and responsiveness, provision of appropriate activities, predictable programs, and provision of play environment and safe home (P <0.05).
    CONCLUSIONS: The results showed that the care for child development program has positive effects on sensitivity and responsiveness skills of mothers of children at risk of developmental delays and can be considered and applied as a practical plan in national health policies.
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  • 文章类型: Journal Article
    Neonatal electroencephalogram (EEG) monitoring guidelines have been published by American Clinical Neurophysiology Society, and the expert consensus on neonatal amplitude-integrated EEG (aEEG) has also been published in China. It is difficult to strictly follow the guidelines or consensus for EEG monitoring in different levels of neonatal units due to a lack of EEG monitoring equipment and professional interpreters. The Subspecialty Group of Neonatology, Society of Pediatrics, Chinese Medical Association, established an expert group composed of professionals in neonatology, pediatric neurology, and brain electrophysiology to review published guidelines and consensuses and the articles in related fields and propose grading management recommendations for EEG monitoring in different levels of neonatal units. Based on the characteristics of video EEG and aEEG, local medical resources, and disease features, the expert group recommends that video EEG and aEEG can complement each other and can be used in different levels of neonatal units. The consensus also gives recommendations for promoting collaboration between professionals in neonatology, pediatric neurology, and brain electrophysiology and implementing remote EEG monitoring.
    美国临床神经生理学协会已经发表了新生儿脑电图监测指南,中国也发表了新生儿振幅整合脑电图(amplitude-integrated electroencephalogram,aEEG)专家共识。由于缺乏脑电监测设备和专业解读人员,不同级别的新生儿病房很难严格按照指南或共识进行脑电监测。中华医学会儿科学分会新生儿学组成立了由新生儿、儿童神经和神经电生理专业人员组成的专家组对已经发表的指南和专家共识及相关领域的文献进行审查,建立了适用于不同级别新生儿病房脑电监测的分层管理建议。基于视频脑电图和aEEG特点,根据当地医疗资源和患儿疾病特征,专家组认为视频脑电图和aEEG可以互相补充应用,适用于不同级别的新生儿病房。该共识对促进新生儿、儿童神经和神经电生理专业人员之间的合作和远程脑电监测实施提出了建议。.
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