胎儿窘迫40例胎心监护分析  

Study of the fetal heart monitoring for fetal distress in 40 cases

作　　者：鲁筱莹[1] 

机构地区：[1]大连市妇产医院,辽宁大连116033

出　　处：《大连大学学报》2005年第4期97-98,101,共3页Journal of Dalian University

摘　　要：[目的]分析各种类型的胎儿监护结果与胎儿窘迫的关系及对手术产率的影响.[方法] 选取2003年～2004年40例胎儿窘迫病例(均≥37周),对其胎心监护结果进行分析.[结果]34例发生于产程各阶段,胎心监护图型分别是晚期减速和变异减速、早期减速、轻度心动过速、轻度心动过缓.各监护图型对应的羊水污染程度具有显著差异(P＜0.05),剖宫产率、Apgar≤7分无显著差异(P＞0.05).[结论] 晚期减速和变异减速是胎儿宫内缺氧的表现,需立即或及时终止妊娠.早期减速、轻度心动过速、轻度心动过缓出现在产程中是胎儿对暂时性缺氧反应良好的表现,临床上一般不需特殊处理,但心动过缓和心动过速伴基线变异减少或消失则提示胎儿窘迫,需及时处理.胎心监护对剖宫产率有一定影响,对于胎儿窘迫诊断可根据胎心监护结合胎儿头皮血气分析综合判断结果更准确.[ Objective] Analyze the relationship between kinds of fetal heart monitoring results and fetal distress as wen as the influence of fetal heart monitoring on operation delivery rate. [ Methods] Choose 40 cases of fetal distress （ 1〉37 weeks） of years 2003 and 2004 and analyze their fetal heart monitoring results. [ Results] 34 cases occurred in each phase of delivery. Fetal heart monitoring graphs show respectively late deceleration, variable deceleration,early deceleration,low-grade tachycardia and low-grade bradycardia. The degree of polluted amniotic fluid corresponding to each graph presents significant difference （P 〈0.05 ） , cesarean delivery rate and Apgar≤7, no significant difference （P 〉 0. 05）. [ Conclusion ] Late and variable deceleration proofs fetal distress, thus gestation should be terminated immediately or timely. Early deceleration, low-grade tachycardia or low-grade bradycardia occurring in the course of delivery is a positive reaction of fetus to temporary oxygen deficiency,thus no special treatment is needed clinically. But tachycardia or bradycardia with baseline variable deceleration or disap- pearance indicates fetal distress, and timely treatment is needed. Fetal heart monitoring exerts a certain effect on cesarean delivery rate. Fetal heart monitoring combined with blood-gas analysis of fetal scalp can make diagnosis of fetal distress more correct.

关 键 词：胎儿窘迫 胎心监护 羊水污染 

分 类 号：R71[医药卫生—妇产科学]