胎心监护无负荷试验中变化减速波形的临床分析  

Clinical analysis of variable deceleration wave in non-stress test

作　　者：李红燕[1] 张祖煌[2] 王谢桐[1] 

机构地区：[1]山东省立医院妇产科,山东济南250021 [2]山东省立医院病案科,山东济南250021

出　　处：《中国实用妇科与产科杂志》2007年第7期523-525,共3页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的探讨胎心监护无负荷试验(NST)中变化减速(VD)发生的影响因素及围生儿结局。方法回顾性分析山东省立医院2001年2月至2005年2月5120例NST中出现VD的283例监护图形,比较不同图形影响因素的发生率和围生儿结局。结果NST中VD的发生率5.53%(283/5120)。单纯VD中影响因素发生率56.49%(87/154),不典型VD中影响因素发生率94.57%(122/129),差异具有显著性意义(χ2=52.7,P<0.01)。在分娩的283例新生儿中,1分钟Apgar评分>7分者252例,≤7分者31例,其中单纯VD组新生儿窒息率2.59%(4/154),而不典型VD组新生儿窒息率20.92%(27/129),差异具有显著性意义(χ2=24.2,P<0.01);单纯VD组剖宫产率(21.43%,33/154)低于不典型VD组(55.04%,71/129),差异具有显著性意义(χ2=34.1,P<0.01)。结论NST中变化减速的发生与多种因素有关,脐带异常最常见,不典型VD较典型者影响因素更明确,新生儿窒息的发生率更高,不典型VD较单纯VD更容易发生胎儿宫内窘迫。Objective To study the influential factors of variable deceleration （VD） in fetal non-stress test（NST） and the newborn outcome. Methods To analyse the monitoring pattern of 283 cases of variable deceleration which occurred in 5120 nonstress tests, and compare the incidence of influential factor which caused different pattern and the newborn outcome. Results The incidence of variable deceleration（VD） was 5.53% （283/5120）. The incidence（56.49%, 87/154） of influential factor which caused simple VD was significantly different from atypical variable deceleration （94. 57% 122/129） （ X^2 = 52. 7, P 〈 0. 01 ）. In the 283 newborns, 1 minute Apgar score 〉 7 was in 252 cases, 〈 7 in 31 cases. The incidence of neonatal asphyxia in simple VD （2. 59% ,4/154） was significantly less than in atypical VD （20. 92%, 27/129） （X^2 =24. 2,P 〈0. 01） . The incidence of cesarean section in simple VD（21.43% ,33/154） was significantly less than that of the atypical VD（55.04% ,71/129） （X^2= 34. 1 ,P 〈0. 01 ）. Conclusion The variable deceleration in NST is associated with many factors,and umbilical cord abnormality is the most common factor. The atypical VD has a more significant influential factor than simple VD;fetal distress occurs in atypical VD more easily than in simple VD.

关 键 词：胎心监护 无负荷试验 变化减速 不典型变化减速 

分 类 号：R71[医药卫生—妇产科学]