经会阴三维超声监测产程进展各参数的可重复性研究  

Replicability of ultrasonic parameters during laboring with three-dimensional transperineal ultrasound

作　　者：田雪叶 韩蓁[1] 全萌 宋青[1] TIAN Xue-ye;HAN Zhen;QUAN Meng;SONG Qing(Department of Obstetrics and Gynecology,The First Affiliated Hospital of Xi an Jiaotong University,Xi an 710061,China)

机构地区：[1]西安交通大学第一附属医院妇产科,陕西西安710061

出　　处：《西安交通大学学报（医学版）》2018年第6期880-884,共5页Journal of Xi’an Jiaotong University（Medical Sciences）

摘　　要：目的评估在同一检查者自身、2位检查者间经会阴三维超声监测第二产程进展各指标测量的可重复性。方法选取本院2016年3月至2016年9月经阴道试产的初产孕妇共48例(单胎、头位),进入第二产程后每隔15min进行一次超声检查,应用Sono VCAD软件由2位检查者分别测量产程进展角、胎头下降距离、胎头方向角、中线角。应用组内相关系数、Bland-Altman分析法来评价检查者自身及检查者间各指标测量的可重复性。结果(1)4个指标中,检查者间的偏差要高于检查者自身的偏差;(2)除中线角外,其余3个指标的可重复性好。其中,产程进展角、胎头下降距离的可重复性最好。结论超声评估第二产程进展的各项参数中产程进展角、胎头下降距离的可重复性较好,是评估产程进展程度的可靠指标。Objective To evaluate the intra-observer and inter-observer replicability of the measurements obtained from three-dimensional(3D)transperineal ultrasound in the second labor.Methods The ultrasonic parameters were obtained from 48 primiparous women(single birth,head-presentation)in the second stage of labor every 15 minutes,from Mar.2016 to Sep.2016,which were scored and separately evaluated by two different operators using the Sono VCAD labor software.The following ultrasonic parameters were measured:head progression angle,head progression distance,head direction,and midline angle.The intra-group correlation coefficient and Bland-Altman analysis method were used to evaluate the intra-observer and inter-observer replicability of the ultrasonic parameters.Results ①Of the four ultrasonic parameters,the inter-observer deviation was higher than the intra-observer one.②The replicability of the other three ultrasonic parameters were better than that of the midline angle.Among them,labor progress and head progression distance had better replicability.Conclusion During monitoring the progress of the second stage of labor with 3D transperineal ultrasound,labor progress and head progression distance had good replicability,indicating that these two ultrasonic parameters were the reliable indicators to assess fetal head progression.

关 键 词：经会阴三维超声 可重复性 超声参数 产程监测 

分 类 号：R714.51[医药卫生—妇产科学]