超声在胎儿脐带绕颈宫内干预方法中的价值探讨  

Means of Intrauterine Intervention to Fetal Nuchal Circular Umbilical Cord

作　　者：陈彦红[1] 许春梅[1] 严思萍[2] 施月秋[2] 郑红雨[1] 韦玲华[1] 黄向红[1] 

机构地区：[1]广西壮族自治区人民医院超声科,南宁市530021 [2]广西壮族自治区人民医院产科,南宁市530021

出　　处：《中国超声医学杂志》2009年第7期694-696,共3页Chinese Journal of Ultrasound in Medicine

基　　金：广西科学基金资助项目（桂科自No.0542065）

摘　　要：目的探索超声在胎儿脐带绕颈的宫内干预方法的价值。 方法随机纳入妊娠中晚期有脐带绕颈的正常单活胎186例，首先借超声检查确定脐带绕颈的缠绕方向及类型，根据缠绕方向及类型，结合孕妇的习惯卧姿，采取相应的卧姿变换。 结果本干预组168例获成功，成功率90．32％，其中7例后期失访，予剔除，修正成功率89．94％（161／179）。1次干预成功者111例，2次者30例，3次者12例，4次者6例，5次者2例。发生复绕者83例，其中34周以前发生复绕者34例（21．12％），34周至分娩前发生复绕者49例（30．43％），保持至分娩不发生复绕者78例（48．45％）。 结论超声干预胎儿脐带绕颈宫内复位的方法成功率高，对临床有重要意义。Objective To investigate the intrauterine diaplastic means of fetal nuchal circular umbilical cord. Methods 186 single fetal of intermediate and advanced stage with nuchal circular umbilical cord were randomized into experiment. The winding directions and rye of nuchal circular umbilical cord were judged correctly fist on color Doppler flow imaging （CDFI） . Corresponding decubitus were adopt according to the winding directions and tye and decubitus custom of pregnant women. Results 90.32% was succeeded （168/186） in this group, and the adjusted achievement ratio was 89.94% （161/179） because 7 patients were visited unsuccessfully at the pregnant advanced stage. 111 patients were successful after one intervention, among them, 30 patients after twice, 12 patients after three times, 6 patients after four times, 2 patients after five times. 78 patients retained to puerperant, but 83 patients had fetal nuchal circular umbilical cord again, and 34 patients of them had before a4 pregnant weeks, 49 patients had from 34 pregnant weeks to puerperant. Conclusions Our investigation indicates that the achievement ratio of the intrauterine diaplastic means of fetal nuchal circular umbilical cord is high. It is very important for clinic.

关 键 词：彩色多普勒血流显像 脐带绕颈 宫内干预 

分 类 号：R714.43[医药卫生—妇产科学] R445.1[医药卫生—临床医学]