多普勒超声技术评价妊娠晚期脐带绕颈胎儿主要动脉血流动力学参数预测胎儿窘迫的临床研究  

Prediction of fetal hypoxia by evaluation of primary arterial hemodynamic parameters in fetuses with umbilical cord around the neck in late pregnancy via Doppler ultrasound

作　　者：张文军[1] 谭静[1] 周秘 兰海[1] 唐茜[1] 张知剑 许达[1] 

机构地区：[1]四川省成都市温江区人民医院超声科,四川成都611130 [2]西南医科大学,四川泸州611731

出　　处：《医学影像学杂志》2016年第6期1079-1082,共4页Journal of Medical Imaging

基　　金：四川省成都市医学重点专科建设资助课题项目:四川省卫生厅科研课题(130533)

摘　　要：目的探讨妊娠晚期脐带绕颈胎儿主要动脉包括脐动脉（UA）、静脉导管（DV）和大脑中动脉（MCA）阻力指标预测宫内缺氧的早期诊断价值。方法运用彩色多普勒超声检测203例28~40孕周的正常胎儿和96例脐带绕颈胎儿的UA、DV和MCA搏动指数（PI）、阻力指数（RI）、收缩期峰值流速与舒张末期流速比值（S/D）,通过对相关血流参数的组间差异性比较,判断脐带绕颈胎儿宫内缺氧情况。结果两组间胎儿心室壁各节段组织速度参数比较无差异（P〉0.05）,两组间静脉导管的PS值及脐动脉的ED值比较有非常显著的差异（P〈0.05）,脐动脉的RI值及大脑中动脉的RI、S/D值的比较有非常显著的差异（P〈0.05）。结论对脐带绕颈胎儿应用彩色多普勒监测UA、DV和MCA血流参数可能对预测胎儿窘迫有重要的临床应用价值。Objective To investigate the value of primary arteys include umbilical artery（ UA）,ductus venosus（ DV） and middle cerebral artery（ MCA） resistance index in predicting fetal hypoxia in fetuses with umbilical cord around the neck in late pregnancy. Methods Two hundred and three normal fetuses between 28 and 40 weeks of gestation and 96 fetuses with umbilical cord around neck were measured for UA,DV and MCA pulsatility index（ PI）,resistance index（ RI） and the peak-systolic / diastolic ratio（ S / D） by color Doppler ultrasonography. By comparing the difference of the blood flow parameters between two groups,determine intrauterine hypoxia in fetuses with umbilical cord around the neck. Results There was no difference in the tissure velocity parameters of each segment of the ventricular wall between the two groups（ P〉0. 05）,but significant differences was found in PS of the ductus venosus,ED and RI of umbilical artery,RI and S / D of middle cerebral artery between the two groups of（ P〈0. 05）. Conclusion Monitoring hemodynamic parameters of UA,DV and MCA by color doppler may help in predicting fetal distess in fetuses with umbilical cord around neck.

关 键 词：超声心动描记术 组织速度成像 心肌 速度达峰时间 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]