胎儿频谱多普勒联合胎儿生物物理学评分对胎儿宫内缺氧的诊断价值  

Value of fetal spectrum Doppler combined with fetal biophysical score in the evaluation of fetal intrauterine hypoxia

作　　者：张凌[1] 王凤[1] 何芳[1] 张敏楠[1] 孟临侠 ZHANG Ling;WANG Feng;HE Fang;ZHANG Min-nan;MENG Lirt-xia(Department of Ultrasound, Baoji Hospital of Traditional Chinese Medicine, Baoji 721001, Shaanxi, CHINA)

机构地区：[1]宝鸡市中医医院超声科,陕西宝鸡721001

出　　处：《海南医学》2019年第5期616-618,共3页Hainan Medical Journal

摘　　要：目的探讨应用彩色多普勒超声血流检测及生物物理评分(BPS)诊断胎儿宫内缺氧的价值。方法将2015年3月至2017年3月宝鸡市中医医院妇产科收治的60例胎儿宫内窘迫孕妇为研究组,并选择60例正常孕妇为对照组,均采用彩色多普勒超声检测大脑中动脉(MCA)、静脉导管(DV)、脐动脉(UA)血流指数,采用B超获得胎儿BPS评分,比较两组孕妇MCA、DV、UA血流指数和BPS评分的差异,并分析超声血流检测、BPS、联合检测诊断胎儿宫内窘迫的价值。结果研究组孕妇BPS评分低于对照组[(4.02±1.92)分vs (6.32±2.59)分],MCAPI、MCAR1、MCAS/D低于对照组[(1.12±0.23) vs (1.85±0.45)、(0.63±0.04) vs (0.79±0.06)、(3.02±0.25) vs (4.97±0.28)],UAPI、UARI、UAS/D、DVPIV、DVPVIV高于对照组[(1.28±0.26) vs (0.81±0.21)、(0.76±0.09) vs (0.52±0.03)、(4.03±0.18) vss (2.06±0.22)、(0.85±0.03) vs (0.60±0.03)、(0.78±0.06) vs (0.50±0.04)],差异均有统计学意义(P<0.05);研究组孕妇BPS、超声血流检测胎儿宫内窘迫的阳性率高于对照组[58.33%vs 20.00%、70.00%vs 25.00%],差异均有统计学意义(P<0.05);研究组联合检测阳性率为88.33%,高于BPS单独检测的58.33%和超声血流检测的70.00%,差异均有统计学意义(P<0.05)。BPS、超声血流检测、联合检测诊断胎儿宫内窘迫的曲线下面积(AUC)分别为0.761 (95%CI:0.364～0.951)、0.803 (95%CI:0.271～0.806)、0.902 (95%CI:0.135～0.947),灵敏度和特异度分别为73.16%、54.61%;81.64%、71.52%;92.34%、95.37%。结论彩色多普勒超声血流检测诊断胎儿宫内窘迫的价值高于生物物理评分,联合检测可提高胎儿宫内窘迫的诊断价值。Objective To evaluate the value of color Doppler flow imaging and biophysical score(BPS) in evaluating intrauterine hypoxia. Methods From March 2015 to March 2017, 60 pregnant women with intrauterine distress were selected as the study group, and 60 normal pregnant women were selected as the control group. The middle cerebral artery(MCA), venous catheter(DV), umbilical artery(UA) blood flow indexes were detected by color Doppler ultrasound. The fetal BPS score was obtained by B ultrasound. The differences in MCA, DV, UA blood flow indexes, and BPS score between the two groups were evaluated, and the value of ultrasonic blood flow detection, BPS, combined detection of fetal distress in the diagnosis of fetal distress was analyzed. Results The BPS score of the study group was lower than that of the control group:(4.02 ± 1.92) vs(6.32 ± 2.59);MCAPI, MCAR1, MCAS/Dwere significantly lower:(1.12±0.23) vs(1.85±0.45),(0.63±0.04) vs(0.79±0.06),(3.02±0.25) vs(4.97±0.28);UAPI, UARI, UAS/D, DVPIV, DVPVIVwere significantly higher:(1.28±0.26) vs(0.81±0.21),(0.76±0.09) vs(0.52±0.03),(4.03±0.18) vs(2.06±0.22),(0.85±0.03) vs(0.60±0.03),(0.78±0.06) vs(0.50±0.04);the differences were all statistically significant(P<0.05). The positive rate of fetal distress in BPS and ultrasonic blood flow detection in the study group was higher than that of the control group:58.33% vs 20.00%, 70.00% vs 25.00%, P<0.05;The positive rate of combined detection in the study group was 88.33%,which was higher than 58.33% for BPS and 70.00% for ultrasound blood flow detection(P<0.05). The area(AUC) of BPS, ultrasound, and combined detection of fetal distress was 0.761(95% CI: 0.364-0.951), 0.803(95% CI:0.271-0.806), and 0.902(95% CI: 0.135-0.947) respectively. The sensitivity and specificity were 73.16%, 54.61%;81.64%, 71.52%;92.34%, 95.37%, respectively. Conclusion The value of color Doppler ultrasound in the diagnosis of fetal distress is higher than that of biophysical score. Combined detection can improve the diagnostic value of feta

关 键 词：彩色多普勒超声 血流检测 生物物理评分 胎儿宫内缺氧 诊断价值 

分 类 号：R714.5[医药卫生—妇产科学]