胎心监护联合彩色多普勒血流成像预测胎儿宫内生长受限价值  

Value of fetal heart monitoring combined with color Doppler flow imaging for predicting fetal intrauterine growth restriction

作　　者：吴海莲 李忠举 吴灵兰 WU Hailian;LI Zhongju;WU Linglan(Dongfang City People's Hospital,Dongfang,Hainan Province,572600;Haikou Hospital Affiliated to XiangyaSchool of Medicine,Central South University,Haikou,Hainan Province)

机构地区：[1]海南省东方市人民医院,572600 [2]中南大学湘雅医学院附属海口医院

出　　处：《中国计划生育学杂志》2023年第2期376-379,384,486,共6页Chinese Journal of Family Planning

基　　金：海南省重点研发计划项目(ZDYF2019179)。

摘　　要：目的:探讨胎心监护联合彩色多普勒血流成像预测胎儿宫内生长受限(IUGR)的临床价值。方法:回顾性分析2017年3月-2020年12月本院收治的356例妊娠晚期孕妇临床资料,根据孕妇分娩后是否为IUGR分为IUGR组31例和对照组325例。比较两组孕期胎心监护结果、彩色多普勒血流成像测量的脐动脉血流参数[搏动指数(PI)、阻力指数(RI)以及S/D值]。绘制受试者工作特征曲线(ROC)分析预测价值。结果:IUGR组胎心监护异常率(83.9%)高于对照组(19.7%),脐动脉血流参数PI(0.90±0.30)、RI(0.75±0.22)、S/D(3.28±0.45)值均大于对照组(0.77±0.24、0.65±0.17、2.85±0.39)(均P<0.05)。胎心监护联合脐动脉S/D值预测IUGR的曲线下面积为0.869,灵敏度93.6%,特异度80.3%。结论:胎心监护联合彩色多普勒血流成像对IUGR有较高的预测价值。Objective: To explore the clinical value of fetal heart monitoring combined with color Doppler flow imaging for predicting fetal intrauterine growth restriction(IUGR). Methods: A retrospective analysis was performed on the clinical data of 356 pregnant women during the third trimester of pregnancy between March 2017 and December 2020. According to the IUGR comfirmed after delivery, these women were divided into group A(31 cases with IUGR) and group B(325 cases without IUGR). The results of fetal heart monitoring, and the values of umbilical artery blood flow parameters measured by color doppler flow imaging, such as pulsatility index(PI), resistance index(RI), and S/D, of the women were compared between the two groups. The predictive value of fetal heart monitoring combined with color Doppler flow imaging was analyzed by receiver operating characteristic(ROC) curve. Results: The abnormal rate of fetal heart monitoring(83.9%) of the women in group A was significantly higher than that(19.7%) of the women in group B. The values of PI(0.90±0.30), RI(0.75±0.22), and S/D(3.28±0.45) of the women in group A were significantly higher than those(0.77±0.24, 0.65±0.17, and 2.85±0.39) of the women in group B(all P<0.05). The area under curve, the sensitivity, and the specificity of the fetal heart monitoring combined with the umbilical artery S/D value for predicting IUGR were 0.869, 93.6%, and 80.3%, respectively. Conclusion: Fetal heart rate monitoring combined with color doppler flow imaging has high predictive value for IUGR of the women.

关 键 词：胎儿宫内生长受限 胎心监护 彩色多普勒血流成像 脐动脉血流 预测 

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