产前超声联合胎心监测预测胎儿宫内窘迫的准确性研究  

Accuracy of prenatal ultrasound combined with fetal heart rate monitoring in predicting fetal distress

作　　者：张慧[1] 贺青文[2] 张顺仓[2] 杨继[2] 

机构地区：[1]陕西省西安市第四医院超声科,西安710004 [2]陕西省西安市第四医院妇产科,西安710004

出　　处：《广西医科大学学报》2017年第11期1588-1590,共3页Journal of Guangxi Medical University

基　　金：陕西省科技计划基金资助项目(No.2014K11-03-09-04);陕西省卫生厅科研基金资助项目(No.2010C08)

摘　　要：目的:探讨产前超声联合胎心监测预测胎儿宫内窘迫的准确性。方法:回顾性分析陕西省西安市第四医院收治的116例孕妇的临床资料,其中发生胎儿宫内窘迫18例(胎儿宫内窘迫组),未发生胎儿宫内窘迫98例(正常组)。两组产前均经超声及胎心监测,记录两组超声监测的脐动脉收缩期最大血流速度/舒张末期血流速度比(S/D)、搏动指数(PI)、阻力指数(RI)及胎心监护无压力试验(NST)差异,并分析产前超声、胎心监测单独及两者联合对胎儿宫内窘迫的诊断价值。结果:两组PI、RI比较,差异无统计学意义(P>0.05)。胎儿宫内窘迫组S/D值、NST反应异常率高于正常组,差异有统计学意义(P<0.05)。超声监测与胎心监测对胎儿宫内窘迫诊断准确率、敏感度、特异度比较,差异无统计学意义(P>0.05)。超声联合胎心监测对胎儿宫内窘迫诊断准确率、敏感度均显著高于单纯超声及胎心监测,且差异有统计学意义(P<0.05)。结论:产前超声、胎心监测均对胎儿宫内窘迫有一定预测作用,两者联合诊断可提高胎儿宫内窘迫窘迫诊断准确度、敏感度,临床应用价值较高。Objective： To investigate the accuracy of prenatal ultrasound examination combined with fetal heart rate （FHR）monitoring in predicting fetal distress. Methods： The clinical data from l 16 pregnant women including 18 cases of fetal distress（fetal distress group）, and 98 cases of fetal distress（normal group）were retrospectively analyzed. All patients received prenatal ultrasound examination and FHR monitoring. The ratio of peak systolic to least diastolic flow velocity（S/D）, pulsatility index （PI）, resistance index （RI）and abnormal rate of NST reaction were recorded. The diagnostic value of prenatal ultrasound examination or FHR monitoring alone and the combination of the two methods in fetal distress was analyzed. Results： No significant difference was found in PI and RI between the two groups（P〉0. 05）. The abnormal rate of S/D and NST reaction in fetal dis- tress group were higher than those in the normal group（P〈0. 05）. There was no significant difference in the diagnostic accuracy, sensitivity and specificity of fetal distress between ultrasound examination and FHR monitoring （P〉0. 05）. The diagnostic accuracy and sensitivity of prenatal ultrasound examination combined with FHR monitoring for fetal distress were significantly higher than ultrasound or FHR monitoring only （P〈 0.05 ）. Conclusion： Prenatal ultrasound and FHR monitoring had predictive value for fetal distress. This combination could improve the diagnostic accuracy and sensitivity of fetal distress.

关 键 词：超声 胎心监测 预测 胎儿宫内窘迫 

分 类 号：R442.8[医药卫生—诊断学]