产前彩色多普勒超声联合胎心无负荷试验在胎儿宫内窘迫诊断中的应用  

Application of prenatal color Doppler ultrasound combined with non-stress test in the diagnosis of fetal distress

作　　者：李凤谊 李振兴[1] 林进[1] 李秋梅[1] 梁理娟 赖华强[1] 蒙万添 

机构地区：[1]肇庆市第二人民医院,广东肇庆526000

出　　处：《现代医院》2017年第7期1067-1069,共3页Modern Hospitals

摘　　要：目的分析产前彩色多普勒超声联合胎心无负荷试验(NST)在胎儿宫内窘迫诊断中的应用价值。方法选择于我院门诊建卡进行常规孕检的150例孕37~42周高危孕妇作为研究对象,均采用胎心监护仪监测胎心,并应用彩色多普勒超声检测作脐动脉血流速度检测,分析产前彩色多普勒超声联合NST对胎儿宫内窘迫的诊断价值。结果本组高危妊娠150例,临床确诊胎儿宫内窘迫72例,占48.00%;NST诊断胎儿宫内窘迫阳性率为55.56%,S/D值为70.83%,两者联合诊断阳性率为80.56%;ST联合S/D诊断灵敏度(80.56%)、特异度(96.15%)最高,漏诊(19.44%)及误诊率(3.85%)最低,与产后诊断一致度最高(kappa=0.671,P<0.05)。结论产前彩色多普勒超声联合胎心无负荷试验可提高胎儿宫内窘迫检出率,为改善围生期胎儿结局提供有效的依据。Objective To analyze the value of prenatal color Doppler ultrasound combined with non - stress test（NST） in the diagnosis of fetal distress. Methods A total of 150 high - risk pregnant women whose gestational age was 37 -42 weeks and who received routine pregnancy test in our hospital were enrolled in the study. All women received fetal heart monitoring with fetus ECG monitor , and the umbilical artery blood flow velocity was detected with color Doppler ultra-sound. The value of prenatal color Doppler ultrasound combined with NST in the diagnosis of fetal distress was analyzed. Re-sults In the study, there were 150 cases with high risk pregnancy , and clinical diagnosis showed fetal distress in 72 cases , accounting for 48. 00% . NST diagnosed that the positive rate of fetal distress was 55. 56% , and the S/D value was 70. 83% . The combined diagnostic positive rate was 80. 56%. The diagnostic sensitivity and specificity of ST combined with S/D were the highest （80. 56% and 96. 15% ） while the missed diagnosis rate and misdiagnosis rate were the lowest （ 19. 44% and 3. 85% ） , of which the consistency with postpartum diagnosis was the highest （ kappa = 0. 671, P 〈 0. 05 ） . Conclusion Prenatal color Doppler ultrasound combined with NST can improve the detection rate of fetal distress, and provide effective ba-sis for improving perinatal fetal outcomes.

关 键 词：彩色多普勒超声 胎心无负荷试验 宫内窘迫 新生儿结局 

分 类 号：R714.5[医药卫生—妇产科学] R543.6[医药卫生—临床医学]