胎盘床动脉血流检测在胎盘功能不良中的临床探讨  

Evaluation on clinical significance of placental insufficience by detection placental bed artery with 4-D coloured doppler

作　　者：李晓云[1] 陈明[2] 

机构地区：[1]广东省深圳市龙岗区妇幼保健院,518172 [2]遵义医学院附属医院产科,贵州遵义563000

出　　处：《中国妇幼卫生杂志》2013年第1期6-7,9,共3页Chinese Journal of Women and Children Health

摘　　要：目的对足月妊娠羊水过少的孕妇进行胎盘床动脉血流检测,探讨其在胎盘功能不良中的临床意义。方法①选择37～40孕周羊水过少的孕妇30例作为观察组,同期正常孕妇30例作为对照组。分别检测胎盘床动脉及脐动脉血流的搏动指数(PI)、阻力指数(RI)、收缩期/舒张末期血流速度比值(S/D);②产程中统计羊水量;③产后取部分胎盘组织送病理、光镜及电镜下观察组织形态学的改变。结果①观察组孕妇胎盘床动脉血流RI、S/D较对照组均升高(P<0.05),PI变化不明显(P>0.05);脐动脉血流仅S/D较对照组升高(P<0.05),RI、PI变化不明显(P>0.05);②观察组的胎盘绒毛具有合体细胞结节、细胞滋养细胞、基底膜增厚、纤维素样沉积及坏死的阳性绒毛,显著高于对照组(P<0.05);③观察组羊水粪染、低体重儿、新生儿窒息、羊水过少等发生例数均明显高于对照组(P<0.05)。结论①胎盘床动脉血流RI、S/D在评价胎盘功能方面较脐动脉血流S/D具有更早的临床价值;②胎盘床血流RI、S/D升高系胎盘绒毛病变所致,可用于预测和改善围产儿结局。[ Objective ] To explore the clinical significance of the placental insufficienc by detecting the aortic flow of placental bed in oligohydramnios. [ Methods ] 1.Thirty cases of oligohydramnios pregnant women in geslation age of 37-40 weeks of pregnancy as observation group were chosen while thirty normal pregnant women as control group. The pulsatility index （PI）, resistance index （RI）, systolic maximum velocity/diastolic minimum velocity （S/D） of placental bed artery and umbilical artery for pregnants from both observation and control groups respectively were examined by using Voluson730; 2. Amniotic fluid was recorded in the stage of labor;3.Taking some placental organ to pathology after delivery were used to observe morphology changes by light microscopy and electron microscopy（EM）. [ Resluts ] 1.After observing and comparing, statistics showed that the placental bed artery＇s RI and S/D （P〈0.05） of pregnants from observation group were higher than pregnants from control group. Value of PI （P〉0.05） did not differ very much when it come from umbilical artery, only umbilical artery＇s S/D （P〈0.05） of pregnants from observation group were higher than pregnants from control group, RI and PI did not differ very much （P〉0.05）;2.The syncytium nodule,cytotrophoblast, basal lamina thickening, celluose deposition and necrosis in positive placental villus were significantly higher than those of the controls（P〈0.05）;3. The incidence rate of epinephelus amniotic fluid, low birth weight infant, asphyxia of newborns, oligohydramnios for observation group were significantly higher than those of controls（P〈0.05）. [ Conclusions ] 1. RI and S/D of placental bed artery are more early clinical significance to evaluate the placental function than the S/D of umbilical arterye;2. Placental villus lesion can lead to RI, S/D promotion, which may be used to predict and improve the perinatal outcome.

关 键 词：胎盘功能不良 胎盘床动脉 脐动脉 病理 

分 类 号：R714.56[医药卫生—妇产科学]