胎儿脐动脉和大脑中动脉血流动力学检查联合胎心监护在胎儿宫内缺氧诊断中的价值  

Value of hemodynamic examination of fetal umbilical artery and middle cerebral artery combined with fetal heart rate monitoring in diagnosis of intrauterine hypoxia

作　　者：宇雪豹[1] 范文涛[1] 柯和平 宋晓艳 

机构地区：[1]武汉科技大学附属汉阳医院,湖北武汉430050

出　　处：《中国妇幼保健》2018年第1期191-193,共3页Maternal and Child Health Care of China

摘　　要：目的探讨胎儿脐动脉(UA)和大脑中动脉(MCA)血流动力学检查联合胎心监护在胎儿宫内缺氧诊断中的价值方法选择2016年9月-2017年6月在武汉科技大学附属汉阳医院行彩色多普勒超声检查并住院分娩的378例晚孕期孕妇为研究对象,将其中117例缺氧胎儿设为观察组,261例正常妊娠者设为对照组,检测两组胎儿UA和MCA血流动力学指标,对比分析胎心监护结果。结果观察组UA搏动指数(PI)、阻力指数(RI)及收缩压与舒张压比值(S/D)均显著高于对照组(均P<0.001);观察组MCA的PI、RI及S/D值均显著高于对照组(均P<0.001);两组UA与MCA的PI、RI及S/D的相应比值均明显低于对照组(P<0.001)。观察组胎心监护异常率为88.0%,对照组为14.6%,两组比较,差异有统计学意义(P<0.001);MCA与UA各项阻力指标比值联合胎心监护的ROC曲线下面积最大,灵敏度及Youden指数最高。结论在预测胎儿宫内缺氧中,彩超检测胎儿MCA、UA联合胎心监护较单纯的胎心监护或彩超检测更安全可靠,可以更准确更及时地发现胎儿缺氧状况。Objective To explore the value of hemodynamic examination of fetal umbilical artery（ UA） and middle cerebral artery（ MCA） combined with fetal heart rate monitoring in diagnosis of intrauterine hypoxia. Methods From September 2016 to June 2017,378 hospitalized late pregnant women receiving color Doppler ultrasound examination and giving birth to their babies in Hanyang Hospital Affiliated to Wuhan University of Science and Technology were selected and divided into observation group（ 117 cases of fetal hypoxia） and control group（ 261 cases of normal pregnancy）. The hemodynamic indexes of UA and MCA in the two groups were detected,the results of fetal heart rate monitoring were compared and analyzed. Results Pulsatility index（ PI）,resistance index（ RI）,and the ratio of systolic blood pressure and diastolic blood pressure（ S/D） of UA in observation group were statistically significantly higher than those in control group（ all P0. 001）. PI,RI,and S/D of MCA in observation group were statistically significantly higher than those in control group（ all P0. 001）. The ratios of PI,RI,and S/D of MCA and UA in observation group were statistically significantly lower than those in control group（ all P0. 001）. The incidence rates of abnormal fetal heart rate monitoring in observation group and control group were 88. 0% and 14. 6%,respectively,there was statistically significant difference between the two groups（ P0. 001）. The area under ROC curve of ratios of PI,RI,and S/D of MCA and UA combined with fetal heart rate monitoring was the largest,the sensitivity and Youden index were the highest. Conclusion Compared with single fetal heart rate monitoring or single color ultrasonography,MCA and UA examination by color ultrasound combined with fetal heart rate monitoring can more accurate and timely detect fetal hypoxia condition in prediction of intrauterine hypoxia.

关 键 词：彩色多普勒超声 脐动脉(UA) 大脑中动脉(MCA) 胎心监护 

分 类 号：R445.1[医药卫生—影像医学与核医学]