急性宫内缺氧静脉导管分流率的动物实验研究  

Ductus Venosus Measurements in the Near-term Hircine Fetus after Intermittent Umbilical Cord Occlusion

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

机构地区：[1]福建医科大学附属第二医院超声科,福建省泉州市362000

出　　处：《中国超声医学杂志》2008年第11期972-975,共4页Chinese Journal of Ultrasound in Medicine

基　　金：福建医科大学科研发展基金项目(No.FJGXY04023)

摘　　要：目的研究静脉导管分流率在胎羊急性宫内窘迫时的变化。方法于妊娠116～130d对12只晚孕山羊(7只实验组,5只对照组)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血流量(QDV)、脐血流量(QUV)、静脉导管分流率(DV分流率)。结果(1)实验组夹闭后静脉导管血流量(QDV)[(70.25±15.47)ml/min～(171.47±72.16)ml/min,P<0.05]、静脉导管分流率(0.24±0.03～0.96±0.3,P<0.05)升高;QUV[(298±67.45)ml/min～(176.29±54.12)ml/min,P<0.05]降低;与对照组差异有统计学意义(P<0.05);(2)实验组QDV、DV分流率与血pH呈负相关(r=-0.681,r=-0.770,P<0.01)、与PaO2呈负相关(r=-0.622,r=-0.797,P<0.01)、与血PaCO2呈正相关(r=0.418,r=0.658,P<0.01)。实验组QUV与血pH呈正相关(r=0.324,P<0.01)、与PaO2呈正相关(r=0.580,P<0.01)、与血PaCO2呈负相关(r=-0.521,P<0.01)。结论彩色多普勒超声检测静脉导管分流率可协助早期诊断胎儿急性宫内缺氧。Objective To evaluate the changes in the distribution ratio of the umbilical venous blood flow to the ductus venosus（DV） in a near-term hircine fetus model with acute hypoxemia.Methods Twelve near-term fetal sheep（5 control group and 7 occlusion group） underwent umbilical cord occlusions（90-sec total cord occlusions 5 times at 30-min intervals）at 116~130 days gestation.The DV blood flow,the umbilical vein（UV） blood flow,the DV/UV ratio were performed 5 minutes before the first umbilical cord occlusions,3 minutes after each occlusion.Results 1.In experimental group animals,the DV blood flow （70.25±15.47 ml/min/kg^171.47±72.16 ml/min/kg,P〈0.05）,the DV/UV ratio （0.24±0.03~0.96±0.3,P〈0.05） increased with cord occlusions,and still significatly rose as compared with the control animals.The UV blood flow（298±67.45 ml/min/kg^176.29±54.12 ml/min/kg,P〈0.05） descented with cord occlusions,and still significatly descented as compared with the control animals.2.There were negative correlation between the DV blood flow,the DV/UV ratio and pH（r=-0.681,r=-0.770,P〈0.01）.There were negative correlation between them and PaO2（r=-0.622,r=-0.797,P〈0.01）.There were significant relationship between them and PaCO2（r=0.418,r=0.658,P〈0.01）.There were significant relationship between the UV blood flow and pH,PaO2（r=0.324,r=0.580,P〈0.01）.There were negative correlation between the UV blood flow and PaCO2（r=-0.521,P〈0.01）.Conclusions Doppler ultrasonographic detection of the DV/UV ratio will be as a new prospective technique in screening of fetal acute hypoxemia.

关 键 词：多普勒 宫内缺氧 静脉导管 脐静脉 

分 类 号：R714.5[医药卫生—妇产科学]