不同脐动脉血流S/D值联合胎心监测对胎儿窘迫的诊断价值研究  

Diagnostic value of different umbilical arterial blood flow S/D value combined with fetal heart rate monitoring for fetal distress

作　　者：马永琴 郑玲 杨爱君[1] 刘青 MA Yongqin;ZHENG Ling;YANG Aijun(Obstetrics and Gynecology Department of Xi’an No.4 Hospital,Xi’an 710004)

机构地区：[1]西安市第四医院妇产科

出　　处：《陕西医学杂志》2019年第6期744-747,共4页Shaanxi Medical Journal

基　　金：陕西省科技计划基金资助项目(2014K11-03-09-04)

摘　　要：目的:研究不同脐动脉血流SD值联合胎心监测对胎儿窘迫的诊断价值。方法:选取产检并分娩的S/D≥3的孕妇95例作为高危组,S/D<3的孕妇232例作为对照组,进行脐动脉血流S/D值和胎心监测。根据诊断结果观察并比较两组孕妇出生1min Apgar评分、羊水污染、生产时迟发减速、新生儿体重、剖宫产、NST异常和胎儿宫内窘迫的发生率;分析并比较两组孕妇胎心监测、脐动脉血流S/D值以及二者联合检测的诊断敏感度、特异度和符合率。结果:高危组孕妇出生1min Apgar评分,羊水污染,生产时迟发减速,新生儿体重,剖宫产,NST异常和胎儿宫内窘迫的发生率显著高于对照组(P<0.05)。脐动脉血流S/D诊断敏感度87.18%,特异度89.16%,符合率88.69%。胎心监测诊断敏感73.07%,特异度88.35%,符合率84.71%。脐动脉血流S/D联合胎心监测诊断敏感度97.43%,特异度91.97%,符合率93.27%。与胎心监测相比,脐动脉血流S/D监测诊断敏感度和符合率显著增高(P<0.05)。联合检测诊断敏感度、特异度和符合率显著高于胎心监测和脐动脉血流S/D监测(P<0.05)。结论:不同脐动脉血流S/D值联合胎心监测可显著提高胎儿窘迫检出率,在临床诊断中能够提供较为可靠的依据,且其操作简便、无创、安全。Objective:To study diagnostic value of different umbilical arterial blood flow S/D value combined with fetal heart rate monitoring for fetal distress.Methods:95 pregnant women with S/D≥3 who were admitted for childbirth and delivery were selected as high-risk group,and 232 pregnant women with S/D<3 were used as control group.S/D value and fetal heart rate of umbilical artery blood flow were monitored.According to the diagnosis results,the Apgar score,amniotic fluid pollution,delayed deceleration during production,neonatal weight,cesarean section,NST abnormality and intrauterine distress were observed and compared between the two groups.The fetal heart rate monitoring,snorkel blood flow S/D value and the combined sensitivity,specificity and coincidence rate of the two groups were analyzed and compared.Results:The high-risk group of pregnant women with 1 min Apgar score,amniotic fluid pollution,delayed deceleration during production,neonatal weight,cesarean section,NST abnormalities and intrauterine distress were significantly higher than the control group(P<0.05).The sensitivity of S/D diagnosis of umbilical artery blood flow was 87.18%,the specificity was 89.16%,and the coincidence rate was 88.69%.The diagnostic sensitivity of fetal heart monitoring was 73.07%,the specificity was 88.35%,and the coincidence rate was 84.71%.The sensitivity of umbilical artery blood flow S/D combined with fetal heart rate monitoring was 97.43%,the specificity was 91.97%,and the coincidence rate was 93.27%.Compared with fetal heart monitoring,the diagnostic sensitivity and compliance rate of umbilical arterial blood flow S/D monitoring were significantly higher(P<0.05).Sensitivity,specificity and coincidence rate of combined detection were significantly higher than fetal heart rate monitoring and umbilical artery blood flow S/D monitoring(P<0.05).Conclusion:Different umbilical arterial blood flow S/D values combined with fetal heart rate monitoring can significantly improve the detection rate of fetal distress,provide a reliable ba

关 键 词：脐动脉血流S/D值 胎心监测 胎儿窘迫 诊断 

分 类 号：R714.5[医药卫生—妇产科学]