胎儿心输出量及大脑中动脉超声多普勒监测在妊娠合并三尖瓣反流中的应用  

ULTRASOUND DOPPLER MONITORING OF FETAL CARDIAC OUTPUT AND MIDDLE CEREBRAL ARTERY IN PREGNANCY COMPLICATED WITH TRICUSPID REGURGITATION

作　　者：詹伏兰[1] 纪晓菁 ZHAN Fulan;JI Xiaojing(Department of Ultrasound,the First Affiliated Hospital of Shantou University Medical College,Shantou 515041,China)

机构地区：[1]汕头大学医学院第一附属医院超声诊断科,广东省汕头市515041 [2]汕头大学医学院第一附属医院国瑞医院超声科

出　　处：《中国煤炭工业医学杂志》2022年第1期31-35,共5页Chinese Journal of Coal Industry Medicine

基　　金：广东省汕头医疗卫生科技计划项目(编号:2017119);广东省自然科学基金(编号:2016A030310075)。

摘　　要：目的通过对比分析正常中孕组及晚孕组、正常中晚孕组及中晚孕妊娠合并三尖瓣反流组胎儿心功能各参数指标及大脑中动脉各测值之间的差异,为临床监测评估及预后指导提供一定的理论基础及临床依据。方法对2018年12月—2021年12月50例正常中孕期(孕周在22-28周)、50例正常晚孕期(孕周在29~35周)以及50例中晚孕妊娠合并三尖瓣反流孕妇进行常规胎儿结构筛查及胎儿超声心动图检查,测量并记录各组之间的LOVT内径、ROVT内径、LCO、RCO、CCO、CCOI以及相应的各组大脑中动脉Vmax、PI、RI各参数值,进行组间比较统计学分析。结果正常的中孕组及晚孕组胎儿均以RCO稍大于LCO,且LCO、RCO、CCO随孕周增长而逐渐增加,二组间比较P<0.05,差别具统计学意义;正常中孕组与中孕合并三尖瓣反流组,大脑中动脉血流RI与PI、LCO与CCO二组间比较(P<0.05),差异有统计学意义。正常中晚孕组与中晚孕妊娠合并三尖瓣反流组组间比较,除大脑中动脉PI与RI值之间差异有统计学意义(P<0.05),其余上述各参数值之间差异无统计学意义(P>0.05)。结论通过超声多普勒对胎儿心输出量、大脑中动脉血流监测,对妊娠合并三尖瓣反流病例的预后评估及临床治疗指导提供重要参考价值。Objective To compare and analyze the differences between the parameters of fetal cardiac function and the measured values of middle cerebral artery in normal middle pregnancy group and late pregnancy group,normal middle and late pregnancy group and middle and late pregnancy complicated with tricuspid regurgitation group,so as to provide a certain theoretical and clinical basis for clinical monitoring,evaluation and prognosis guidance.Methods Routine fetal structure screening and fetal echocardiography were performed in fifty normal middle pregnancy(22~28 weeks of gestation),50 normal late pregnancy(29~35 weeks of gestation)and 50 middle and late pregnancy pregnant women with tricuspid regurgitation.The internal diameter of LOVT and ROVT,LCO,RCO,CCO,ccoi and the Vmax,PI,RI of middle cerebral artery blood flow parameters were compared and statistically analyzed between groups.Results RCO was slightly larger than LCO in normal middle and late pregnancy group,the LCO,RCO and CCO increased gradually with the increase of gestational weeks(P<0.05).RI and PI of middle cerebral artery blood flow,LCO and CCO were significant difference between normal middle pregnancy group and middle pregnancy combined with tricuspid regurgitation group(P<0.05).There was no significant difference between the normal middle and late pregnancy group and the middle and late pregnancy complicated with tricuspid regurgitation group,except for the difference between the PI and RI values of the middle cerebral artery(P<0.05),the others were no statistically significant difference.Conclusion The monitoring of fetal cardiac output and middle cerebral artery by ultrasonic Doppler can provide important reference value for the prognosis evaluation and clinical treatment of pregnancy complicated with tricuspid regurgitation.

关 键 词：胎儿超声心动图 胎儿心输出量 大脑中动脉 妊娠合并三尖瓣反流 

分 类 号：R71[医药卫生—妇产科学]