平卧位超声检查时长对晚孕胎儿脐动脉血流参数及胎儿心率的影响  

Influence of the ultrasound examination duration using supine position on umbilical artery blood flow parameters and fetal heart rate in the third-trimester pregnant women

作　　者：冯蕾[1] 李焕菊 赵红岩 Feng Lei;Li Huanju;Zhao Hongyan(Department of Ultrasound,the Fourth Medical Center of PLA General Hospital,Beijing 100048,China;Lishilu Outpatient,Chinese PLA Rocket Force General Hospital,Beijing 100045,China)

机构地区：[1]解放军总医院第四医学中心超声科,北京100048 [2]火箭军总医院礼士路门诊部,北京100045

出　　处：《中国综合临床》2019年第6期548-552,共5页Clinical Medicine of China

摘　　要：目的探讨平卧位超声检查时长对晚孕胎儿脐动脉血流参数的影响。方法回顾性分析2019年2月至2019年6月解放军总医院第四医学中心就诊的93例晚孕孕妇超声资料。比较93例晚孕孕妇在超声检查初及常规超声检查后(胎儿、羊水及胎盘等)胎儿脐动脉收缩期峰值流速/舒张末期血流速度(systolic/diastolic,S/D)、阻力指数(resistance index,RI)、搏动指数(pulsatility index,PI)及胎儿心率的变化情况。将孕29~31周47例孕妇作为孕30周组,孕35~37周46例孕妇作为孕36周组,分别比较两组孕妇检查初及常规检查后自身配对S/D、RI、PI及心率的变化。将超声检查初脐动脉S/D正常的65例孕妇作为初始正常组,超声检查初脐动脉S/D异常的28例孕妇作为初始异常组,分别比较初始正常组、初始异常组孕妇检查初及常规检查后自身配对S/D、RI、PI及心率的变化。结果超声检查初及常规检查后,孕30周组孕妇脐动脉S/D、RI、PI及心率差异均无统计学意义(P均>0.05);孕36周组检查前RI为0.56±0.05,常规检查后升高至0.58±0.05,差异有统计学意义(t=-2.190,P=0.034)。初始正常组65例孕妇常规检查后脐动脉S/D、RI及PI分别由2.36±0.31、0.57±0.06、0.84±0.11升高至2.50±0.42、0.59±0.06、0.88±0.14,差异有统计学意义(t值分别为-3.087、-3.002、-2.287,P值分别为0.003、0.004、0.025),其中16例S/D升高至异常;初始异常组28例孕妇常规检查后脐动脉RI由0.67±0.05下降至0.65±0.06,差异有统计学意义(t=2.616,P=0.014),其中14例孕妇S/D降至正常。初始异常组孕妇经过常规检查后S/D降至正常的比例(14/28),高于初始正常组孕妇经常规检查后S/D升高至异常的比例(16/65),差异有统计学意义(χ^2=5.771,P<0.05)。结论晚孕孕妇行胎儿超声检查时,宜在超声检查初即进行脐动脉血流参数测定;超声检查初S/D异常孕妇,在检查过程中应多次重复测量观察S/D变化情况。Objective To investigate the influence of the length of time of supine ultrasound examination on the parameters of umbilical artery blood flow in the late pregnant fetus.Methods From February 2019 to June 2019,the ultrasound data of 93 pregnant women with the third-trimester pregnant were analyzed retrospectively.Fetal umbilical artery systolic/diastolic(S/D)ratio,resistance index(RI),pulsatility index(PI)and fetal heart rate(HR)were acquired at the beginning of the ultrasound examination and those after the routine ultrasound examination(the examination of fetal,placenta and amniotic fluid).Forty-seven pregnant women from 29 to 31 weeks of gestation were assigned to around 30-week gestation group,while 46 pregnant women from 35 to 37 weeks of gestation were assigned to around 36-week gestation group.Sixty-five pregnant women with normal S/D ratio at the beginning were assigned to the initial normal group,while 28 pregnant women with abnormal S/D ratio at the beginning were assigned to the initial abnormal group.Fetal umbilical artery S/D ratio,RI,PI and HR at the beginning of the ultrasound and after the routine ultrasound examination were compared using paired sample test within around 30-week gestation group,around 36-week gestation group,initial normal and initial abnormal group,respectively.Results There was no significant difference in fetal umbilical artery S/D,RI PI and HR in the pregnant women at around 30-week gestation(all P>0.05).RI before the 36 week pregnant group was 0.56±0.05,and increased to 0.58±0.05 after the routine examination(t=-2.190,P=0.034).The S/D,RI and Pi of umbilical artery increased from 2.36±0.31,0.57±0.06,and 0.84±0.11 to 2.50±0.42,0.59±0.06,and 0.88±0.14 in the initial normal group(t=-3.087,-3.002,-2.287,respectively;P=0.003,0.004,0.025,respectively),of which 16 S/D increased to abnormal;the RI of umbilical artery increased from 0.67 in the initial abnormal group(28 women)after routine examination).The difference was statistically significant(t=2.616,P=0.014).The ratio of

关 键 词：脐动脉血流 晚孕 平卧位 

分 类 号：R71[医药卫生—妇产科学]