超声监测胎儿血流动力学变化预测胎儿生长发育的价值  

Value of Ultrasound Monitoring of Fetal Hemodynamics in the Prediction of Fetal Growth and Development

作　　者：张晓颖[1] 成建萍[1] 

机构地区：[1]南通大学附属医院超声科,江苏南通226001

出　　处：《医学临床研究》2013年第12期2379-2381,共3页Journal of Clinical Research

摘　　要：【目的]探讨超声检测胎儿动静脉的血流动力学参数和径线对预测胎儿生长发育的价值。【方法】回顾性分析产前二维超声及彩色多普勒血流显像对170例胎儿进行各项参数测定，根据测定结果，将其分为正常对照组和宫内生长迟缓（IUGR）组，测量脐动脉、大脑中动脉、颈内动脉和腹主动脉的搏动指数（PI）、阻力指数（RI）及脐动脉收缩期最大流速与舒张末期流速的比值（S／D），测量胎儿静脉导管血流量（QDV）和脐静脉的血流量（QuV），计算静脉导管（DV）分流率，测定胎儿升主动脉和肺动脉收缩期峰值速度（PFV），测量一般径线包括胎儿的双顶径、头围、腹围、股骨长度，测量产后胎儿体重并进行Apgar评分。【结果]IUGR组脐动脉和腹主动脉的PI、RI及S／D测值明显比对照组增高，IUGR组大脑中动脉和颈内动脉的PI、RI及S／D测值比对照组低，IUGR组升主动脉和肺动脉的PFV明显低于对照组胎儿，差异具有统计学意义（P〈0．05）。两组胎儿的QDV无明显差异，但IUGR组的QuV显著下降且DV分流率显著升高，差异均有统计学意义（P〈0．05）。36周IUGR组的胎头双顶径（BPD）、胎儿头围（HC）、胎儿腹围（AC）和胎儿股骨长（FL）明显比对照组低，差异有统计学意义（P〈0．05）。【结论】超声通过综合监测胎儿血流动力学和一般径线的变化，可以全面、客观地评价胎儿生长发育情况。[Objective] To explore the value of ultrasonic monitoring of fetal venous hemodynamic parame ters and warp in the prediction of fetal growth and development. [Methods] The parameters of 170 fetuses were measured and analyzed by 2D ultrasonography and color Doppler flow imaging retrospectively. According to the measurement results, all fetuses were divided into control group and intrauterine growth retardation（IU- GR） group. The pulsatility index （PI） and resistance index （RI） and umbilical artery peak systolic velocity and end diastolic velocity ratio（S/D） of umbilical artery, middle cerebral artery, carotid artery and abdominal ar- tery were measured. Fetal venous catheters and umbilical vein blood flow were also measured. Venous cathe- ters（DV） diversion rate was calculated. Fetal ascending aorta and pulmonary artery peak systolic velocity （PFV） was measured. Fetal biparietal diameter（BPD）, head circumference（HC）, abdominal circumference （AC） and femur length（FL） were measured. The postpartum fetal weight was measured. Apgar score was ob- served. The results were analyzed. [Results] The PI, RI and S/D of umbilical artery and abdominal aorta in IUGR group were obviously higher than those in control group, while PI, RI and S/D of middle cerebral ar- tery and internal carotid artery in IUGR group were obviously lower than those in control group, and the PFV of ascending aorta and pulmonary artery in IUGR group were obviously lower than those in control group, and there was significant difference（ P 〈0.05）. There was no significant difference in QDV between two groups, but the QUV in IUGR group was markedly decreased and DV shunt was markedly increased, and there was significant difference（ P 〈0.05）. The 36-week BPD, HC, AC and FL in fetuses of IUGR group were obviously lower than those of control group, and there was significant difference（ P 〈0.05）. [Conclusion] Ultra- sound monitoring of the changes of fetal hemodynamics and general warp can comprehensive

关 键 词：胚胎发育 血流动力学 超声检查 产前 

分 类 号：R714.51[医药卫生—妇产科学]