脐带绕颈胎儿静脉导管及右心室Tei指数预测胎儿宫内窘迫的价值研究  

Value of fetal ductus venous index and right ventricular Tei index in predicting fetal distress in fetuses with nuchal cord

作　　者：徐芳 支芬燕 陈道芳 姚宏 任晓玲 郭强 XU Fang;ZHI Fenyan;CHEN Daofang;YAO Hong;REN Xiaoling;GUO Qiang(Department of Ultrasound Medicine,Jinshan Branch of Shanghai Sixth People’s Hospital,Shanghai 201599,China)

机构地区：[1]上海第六人民医院金山分院超声医学科,上海201599

出　　处：《中国优生与遗传杂志》2021年第2期202-204,共3页Chinese Journal of Birth Health & Heredity

基　　金：上海市金山区卫计委科研基金(JSKJ-KTMS-2018-11)。

摘　　要：目的通过测量脐带绕颈胎儿临产前静脉导管血流指数和右心室Tei指数,分析静脉导管血流指数和胎儿右心室Tei指数在预测脐带绕颈胎儿宫内窘迫中的价值。方法选取孕龄为37~40+3周的孕妇275例,其中脐带绕颈89例(依照脐动脉S/D值分为S/D≥3组和S/D<3组),正常胎儿186例为对照组。测量各组胎儿静脉导管血流参数,包括心室收缩期血流峰值(S-wave)、心室舒张早期血流峰值(D-wave)、心房收缩期血流速度(A-wave),计算阻力指数(RI)、搏动指数(PI)及S/A值;之后应用TDI技术显示胎儿三尖瓣前叶与三尖瓣环交界处组织多普勒,测量右心室等容收缩时间(ICT)、等容舒张时间(IRT)及射血时间(ET),计算胎儿右心室Tei指数。最后综合评估上述参数。结果脐带绕颈且S/D≥3组胎儿较脐带绕颈且S/D<3组及对照组胎儿DV指数及右心室Tei指数增高,差异具有统计学意义(P<0.05);脐带绕颈且S/D<3组胎儿DV指数及右心室Tei指数与对照组相比,差异无统计学意义。结论通过对脐带绕颈胎儿临产前静脉导管血流指数和右心室Tei指数研究,可为临床评估脐带绕颈胎儿宫内窘迫的诊断提供重要信息。Objective By measuring ductus venous index and right ventricular Tei index to analyze their value in predicting intrauterine distress of fetuses with umbilical cord around the neck.Methods Totally 275 pregnant women with gestational age of 37–40+3 weeks were selected,89 fetuses with umbilical cord around the neck.According to the S/D ratio of umbilical artery,they were divided into S/D≥3 group and S/D<3 group,and 186 normal fetuses were used as the control group.Ductus venous index were measured,including S-wave,D-wave,A-wave,and calculate resistance index(RI),pulsation index(PI),and S/A index.Then,use TDI to display the tissue doppler at the junction of tricuspid anterior lobe and tricuspid annulus in fetus of the right ventricle to measure isovolumic contraction time(ICT),isovolumic relaxation time(IRT)and ejection time(ET),and calculate Tei index.Results Compared with the other two groups,the fetuses with umbilical cord around neck and S/D≥3 had higher ductus venosus(DV)index and right ventricular Tei index(P<0.05).Compared with the control group,there was no significant difference in DV index and right ventricular Tei index between the group with umbilical cord around the neck and S/D<3.Conclusion The study on ductus venous index and right ventricular Tei index of fetuses with umbilical cord around the neck before delivery can provide important information for clinical evaluation of fetal intrauterine distress.

关 键 词：脐带绕颈 静脉导管 TEI指数 宫内窘迫 

分 类 号：R714.5[医药卫生—妇产科学]