双胎之一脐血流S/D值异常增高的早期干预治疗对胎儿结局的影响  

Effect of early intervention treatment on fetal outcomes with abnormally increased S/D value of umbilical blood flow in twins

作　　者：武菁菁 李聪 马秀玲 郭月华 王晓云 翟红卫[1] 马文革 蔡银素[1] WU Jing-jing;LI Cong;MA Xiu-ling;GUO Yue-hua;WANG Xiao-yun;ZHAI Hong-wei;MA Wen-ge;CAI Yin-su(Department of Obstetric,Shijiazhuang Sixth Hospital,Shijiazhuang 050000,Hebei,China)

机构地区：[1]石家庄市第六医院产科,河北石家庄050000

出　　处：《川北医学院学报》2020年第1期45-48,共4页Journal of North Sichuan Medical College

基　　金：河北省卫生厅科研项目(20181080)。

摘　　要：目的:观察早期干预对双胎之一脐血流S/D值异常增高胎儿的影响。方法:选取100例双胎之一脐血流S/D值异常增高的胎儿进行观察,其中异常胎儿为观察组,正常胎儿为对照组。观察两组胎儿出生后发病情况、1年后体格及神经精神发育情况;对于异常胎儿给予吸氧、复方丹参治疗或不治疗,观察不同早期干预对胎儿影响;对各治疗组进行分娩孕周与新生儿体重对比;单绒毛膜双羊膜囊(MCDA)组和双绒毛膜双羊膜囊(DCDA)组的两新生儿均有异常的病例作为阳性病例,统计阳性率并比较绒毛膜性不同的情况下双胎中一胎儿脐血流增高对另一胎儿的影响。结果:脐血流S/D值异常增高胎儿出生时发病率明显增高,生长过程中体格发育及神经精神发育相对落后,给予早期干预后可有效改善,且复方丹参效果要优于单纯吸氧;孕周越小,胎儿出生体重越轻,早期干预可有效增加新生儿体重,复方丹参效果要好于吸氧(P<0.05);MCDA组双胎中一胎儿脐血流增高对另一胎儿的影响与DCDA组比较,差异无统计学意义(P>0.05)。结论:通过吸氧和复方丹参等早期干预可有效改善双胎之一异常胎儿出生时的发病率,提高胎儿出生质量以及新生儿后期的生长发育质量。Objective:To observe the effect of early intervention on the abnormally elevated S/D value of umbilical blood flow in twins.Methods:100 cases of twins with umbilical blood flow S/D abnormally increased fetus were observed.The abnormal fetus was the observer and the normal fetus was the control group.The postnatal morbidity,the physical and neuropsychological development after 1 year of the two groups were observed.For the abnormal fetal administration of oxygen,compound Danshen treatment or no treatment,observe the impact of different early intervention on the fetus,comparison of gestational weeks and neonatal weight in each treatment group,both the single-sling group and the double-wool group have abnormal cases as positive cases,statistical positive rate,comparing the effects of increased fetal umbilical cord blood flow to another fetus in a twin fetus with different chorionicity.Results:The S/D value of umbilical blood flow increased abnormally,the incidence of fetal growth was significantly increased.The physical development and neuropsychiatric development were relatively backward during the growth process.It could be effectively improved after early intervention,and the effect of compound Danshen was better than that of simple oxygen absorption.The smaller the gestational age,the lighter the weight,and the early intervention could effectively increase the weight of the newborn and the effect of compound Danshen was better than that of oxygen(P<0.05).There was no significant difference between the MCDA twins in the fetal cord blood flow and the other fetuses in the DCDA group(P>0.05).Conclusion:Early intervention such as oxygen inhalation and compound salvia miltiorrhiza can effectively improve the incidence of abnormal fetal birth,improve the birth quality of the fetus and the growth and development quality of the newborn.

关 键 词：双胎 脐血流异常 早期干预 

分 类 号：R714.2[医药卫生—妇产科学]