6例胎儿宫内输血的临床应用分析  

Analysis on clinical application of fetal intrauterine transfusion for six fetuses

作　　者：邓璐莎[1] 郭晓玲[1] 鲁云涯[1] 钟进[1] 

机构地区：[1]佛山市妇幼保健院,广东佛山528000

出　　处：《中国妇幼保健》2016年第12期2485-2487,共3页Maternal and Child Health Care of China

基　　金：佛山市科技局项目(201008075)

摘　　要：目的探讨胎儿宫内输血临床应用的安全性及监测指标选择。方法收集行宫内输血的孕妇共6例,对6例宫内输血孕妇的大脑中动脉血流速度(MCA-PSV)、大脑中动脉血流阻力(MCA-RI)、脐动脉血流速度(UA-PSV)、脐动脉血流阻力(UA-RI)进行监测,比较输血前后MCA-PSV、MCA-RI、UA-PSV、UA-RI的差值。结果 6例宫内输血病例中,3例顺利分娩,2例死胎引产,1例新生儿因肺发育不良,呼吸窘迫死亡。输血前后,MCA-PSV差值与UA-RI的差值存在统计学差异(P<0.05),MCA-RI与UA-PSV的差值无统计学差异(P>0.05)。结论严格掌握手术适应证是宫内输血成功的关键,MCA-PSV及UA-RI是预测宫内输血预后的良好指标。Objective To explore the safety of clinical application of fetal intrauterine transfusion and choice of monitoring indexes. Methods Six pregnant women who received intrauterine transfusion were collected. Peak systolic velocity of middle cerebral artery （ MCA- PSV）, resistance index of middle cerebral artery （MCA-RI） , peak systolic velocity of umbilical artery （UA-PSV）, and resistance index of umbilical artery （UA-R1） were monitored in these 6 patients, and Delta values of MCA-PSV, MCA-RI, UA-PSV, and UA-RI before and after blood transfusion were compared. Results Among these 6 cases treated by intrauterine transfusion, three cases had successful birth, two cases were stillbirth abortion, one case died of pulmonary hypoplasia and respiratory distress syndrome. Before and after blood transfu- sion, Delta values of MCA-PSV and UA-RI had statistically significant difference （ P〈O. 05）, while Delta values of MCA-RI and UA-PSV had no statistically significant difference （ P〉0. 05 ） . Conclusion Strictly mastering the surgical indications is critical for successful intra- uterine transfusion. MCA-PSV and UA-RI are good indicators for predicting the prognosis of intrauterine transfusion.

关 键 词：宫内输血 大脑中动脉血流速度 大脑中动脉血流阻力 脐动脉血流速度 脐动脉血流阻力 

分 类 号：R714.5[医药卫生—妇产科学]