脐血流测定对产时胎儿窘迫的监护作用  

The function of surveillance to fetus distress by unbilical flow graphy at the time of clelivery.

作　　者：张爱萍[1] 邱锦萍[1] 

机构地区：[1]成都铁路中心医院妇产科,四川成都610081

出　　处：《四川医学》2008年第12期1669-1670,共2页Sichuan Medical Journal

摘　　要：目的研究胎儿脐血流测定对产时胎儿窘迫的监护价值。方法对344例单胎足月头位妊娠的孕妇进行产时脐血流测定,报告结果显示:脐动脉血流速度指数(S/D)、脉动指数(PI)、阻抗指数(RI)、快速血流比(PVR)4项指标,其中:A.4项指标均正常;B.S/D异常其余各项有1项或多项异常;C.S/D正常其余各项有1项或多项异常。以此为界分为A、B、C 3组进行分析,B组与A组、C组与A组比较,常规探查左右下腹部及耻骨联合上方有无脐血流声像图,以帮助排查胎儿脐绕颈。结果B组胎儿窘迫发生率及剖宫产率明显高于A组;73例脐带绕颈有64例在孕妇左右下腹部及耻骨联合上方探及脐血流声像图。结论当S/D值异常(S/D≥2.7)提示胎儿窘迫,为临床医生诊断产时胎儿窘迫提供可靠依据。孕妇左右下腹部及耻骨联合上方均探及胎儿脐血流图时,绝大多数为胎儿脐带绕颈。Objective Discussing the value of surveillance to fetus distress by umbilical blood flow graphy at the time of delivery. Methods 344 cases with single fetus with full gestation time in encephalar position were selected to be undergone umbilical blood flow graphy when delivery. The report shows us：according to the results of all the fore： guide line including S/D, PI, RI, and FVR, it was divided into three groups：group A, all four guide line are normal;group B, one or more was or were abnormal with S/D was abnormal as well;group C, one or more was or were abnormal apart from S/D was normal. Comparing group A with group B, and group A with group C respectively,detecting bilateral lower abdominal region and superpubic area to see if there is umbilical blood to rule out umbilical encircling fetal neck. Results The ratio of fetus distress in group B is obviously higher than in group A. in 73 cases with umbilical encircling fetal neck, there was umbilical blood flow being detected in 64 cases through probing bilateral lower abdominal region and superpubic area. Conclusion When S/D was abnormal （S/D 2.7 ）, it is suggestive of fetal distress, which helps the gynecologist to diagnose fetal distress with dependable clues. When umbilical blood flow was probed in bilateral lower abdominal region and in superpubie area,it is strongly suggestive of umbilical encircling fetus neck.

关 键 词：脐血流图 胎儿窘迫 监测 分娩方式 

分 类 号：R714.5[医药卫生—妇产科学]