胎羊间断性脐带闭塞对静脉导管血流动力学的影响  

Ductus venosus measurements in the fetal sheep after intermittent umbilical cord occlusion

作　　者：何韶铮[1] 吕国荣[1] 李伯义[1] 陈秋月[1] 苏瑞娟[1] 金鹏[1] 

机构地区：[1]福建医科大学附属第二医院,福建泉州362000

出　　处：《中国医学影像技术》2008年第5期759-762,共4页Chinese Journal of Medical Imaging Technology

基　　金：福建医科大学科研发展基金项目(FJGXY04023)资助

摘　　要：目的探讨胎羊间断性脐带闭塞后静脉导管血流频谱变化的意义。方法12只晚孕山羊(7只实验组,5只对照组)于妊娠116~130d行宫内外科手术,用套囊充气闭合器完全夹闭脐带,每次夹闭90s,间隔30min,重复5次。于实验前5min、每次夹闭后3min应用彩色多普勒超声检测静脉导管心室收缩期峰值速度(Vmax)DV、静脉导管峡部的内径(DDV)、搏动指数(PIDV)、DV指数(S-a/S)、血流量(QDV)。结果实验组夹闭后DDV[(1.99±0.16)^(2.69±0.53)mm,P<0.05)]、QDV[(70.25±15.47)^(171.47±72.16)ml/min,P<0.05)]、PIDV[(0.33±0.09)^(0.7±0.2),P<0.05)]、DV指数[(0.44±0.04)^(0.62±0.11),P<0.05)]升高;与对照组差异有统计学意义(P<0.01)。实验组DDV、QDV、PIDV、DV指数与血pH呈负相关(r=-0.579,r=-0.681,r=-0.358,r=-0.310,P<0.01)、与PaO2呈负相关(r=-0.564,r=-0.622,r=-0.435,r=-0.483,P<0.01)、与血PaCO2呈正相关(r=0.510,r=0.418,r=0.699,r=0.423,P<0.01)。(Vmax)DV与血气指标无明显相关。结论静脉导管血流频谱可成为预测胎儿宫内缺氧的有效指标。Objective To explore the significance of the ductus venosus （DV） Doppler spectrum in fetal sheep with inter mittent umbilical cord occlusion （UCO）. Methods Twelve late pregnancy sheep （5 for control group and 7 for occlusion group） underwent umbilical cord occlusions （90 s total cord occlusions for 5 times at 30 min intervals） at 116- 130 days gestation. The maximum velocity of DV （Vmax）DV, the DV diameter （DDV）, the DV pulsation index （PIDv）, the DV index （ventricular systole-atrial systole/ventricular systole）, the DV blood flow were performed for 5 minutes before the first um bilical cord occlusions and 3 minutes after each occlusion. Results In experimental group animals, the DDV（ [1. 99±0. 163 - E2.69±0. 533mm, P〈0. 05）, theDV blood flow （[70.25±15.47]-[171.47±72.163ml/min, P〈0. 05）, PIDV（[0. 33±0. 09]-[0. 7 ±0. 23, P〈 0. 05）, the DV index （[0. 44 ±0. 04]-[0. 62±0. 11], P〈0. 05 ） increased with cord occlusions, and still significantly rose when compared with the control animals. There were negative correlation between DDV, the DV blood flow, Plov, the DV index and pH （r= -0. 579, r=-0. 681, r=-0. 358, r= -0. 310, P〈0. 01）. There were negative correlation between them and PaO2（r=-0.564, r=-0.622, r=-0.435, r=-0.483, P〈0. 01）. There was sig- nificant correlation between them and PaCO：（r=0.510, r=0.418, r=0.699, r=0.423, P〈0. 01）. There was no significant correlation between （Vmax）DV and Mood gas or pH. Conclusion The ductus venosus Doppler spectrum might be an useful quantitative parameter for assessing fetal hypoxemia.

关 键 词：脐带闭塞 胎儿缺氧 静脉导管 

分 类 号：R714.56[医药卫生—妇产科学] R445.1[医药卫生—临床医学]