胎儿心脏超声对足月胎儿出生后血液动力学变化的影响  

The Effects of Fetal Cardiac Ultrasound on Hemodynamic Changes of Full-term Fetus after Birth

作　　者：仲丽美 贾红娥[2] 薛红红[2] 姜珏[3] 淡敏 ZHONG Li-mei;JIA Hong-e;XUE Hong-hong;JIANG Jue;DAN Min(Medical Ultrasound Center,Northwest Women and Children's Hospital,Xi'an,Shaanxi,710016,China;Department of Ultrasound Medicine,Affiliated Hospital of Yan'an University,Yan'an,Shaanxi,716000,China;Department of Ultrasound,Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shaanxi,710004,China)

机构地区：[1]西北妇女儿童医院医学超声中心,陕西西安710016 [2]延安大学附属医院超声医学科,陕西延安716000 [3]西安交通大学第二附属医院超声科,陕西西安710004

出　　处：《现代生物医学进展》2021年第10期1978-1981,共4页Progress in Modern Biomedicine

基　　金：陕西省社会发展基金项目(2019SF072)。

摘　　要：目的:探讨胎儿心脏超声对足月胎儿出生后血液动力学变化的影响.方法:2018年7月1日到2020年6月30日选择在本院分娩的足月胎儿22750例,其中高危分娩组872例,正常分娩组21878例.所有胎儿都给予心脏超声,记录血液动力学变化情况并进行相关性分析.结果:所有胎儿的超声图像评分≥2分,平均2.87±0.14分,符合诊断要求.高危分娩组的主动脉与肺动脉FHR值高于正常分娩组(P<0.05),PTV值低于正常分娩组(P<0.05).高危分娩组的脐动脉RI与PI值高于正常分娩组(P<0.05),而大脑中动脉RI与PI值低于正常分娩组(P<0.05).在高危分娩组中,随访确诊先心病45例,发生率为5.2%;正常分娩组随访确诊32例,发生率为0.1%,对比差异有统计学意义(P<0.05).在足月胎儿22750例中,Pearson相关分析显示先心病与脐动脉RI、PI值、主动脉和肺动脉FHR值、PTV值都存在相关性(P<0.05).结论:胎儿心脏超声可反映足月胎儿出生后血液动力学变化情况,可指导临床医师及时对高危分娩作出适当处理.Objective:To investigate the effects of fetal cardiac ultrasound on the hemodynamic changes of full-term fetuses after birth.Methods:A total of 22,750 full-term fetuses,who were delivered in Northwest Women and Children’s Hospital from July 1,2018 to June 30,2020,were selected and were divided into high-risk delivery group(n=872)and normal delivery group(n=21,878).All the fetuses were examined by cardiac ultrasound,and their hemodynamic changes were recorded and analysed.Results:The ultrasound image scores of all fetuses were≥2 points,with the average of 2.87±0.14 points,which accorded with the diagnostic requirements.The FHR values of the aorta and pulmonary artery in th group(P<0.05),and the PTV values were lower than those in the normal delivery group(P<0.05).The RI and PI values of the umbilical artery in the high-risk delivery group were higher than those in the normal delivery group(P<0.05),while the middle cerebral artery RI and PI values were lower than the normal delivery group(P<0.05).High-risk delivery group were higher than those in the normal delivery In the high-risk delivery group,there were 45 cases of congenital heart disease diagnosed by followed-up,the incidence rates were 5.2%;and in the normal delivery group,there were 32 cases of congenital heart disease diagnosed by followed-up,the incidence rates were 0.1%,with statistically significant differences(P<0.05).In the 22,750 full-term fetuses,Pearson correlation analysis showed that congenital heart disease was correlated with umbilical artery RI,PI,aortic and pulmonary artery FHR,and PTV values(P<0.05).Conclusions:Fetal echocardiography can reflect the hemodynamic changes of full-term fetuses after birth,and can coach clinicians in dealing promptly with high-risk delivery.

关 键 词：足月胎儿 心脏超声 血液动力学 高危分娩 相关性 

分 类 号：R714.5[医药卫生—妇产科学] R445.1[医药卫生—临床医学]