彩超监测大脑中动脉血流动力学参数对胎儿宫内窘迫的诊断价值  

Diagnostic value of ultrasonography in monitoring the hemodynamic parameters of middle cerebral artery for fetal distress in utero

作　　者：于海霞 李斌 肖雪花 YU Haixia;LI Bin;XIAO Xuehua(Department of Ultrasound,Affiliated Hospital of Jiujiang University,Jiangxi Province,Jiujiang332000,China)

机构地区：[1]九江学院附属医院超声科,江西九江332000

出　　处：《中国当代医药》2023年第13期126-129,F0003,共5页China Modern Medicine

基　　金：江西省卫生计生委科技计划项目(20197215)。

摘　　要：目的探讨彩超监测大脑中动脉血流动力学参数对胎儿宫内窘迫的诊断价值。方法回顾性分析2021年5月至2022年7月于九江学院附属医院进行产检的80例孕妇的临床资料,依据是否发生胎儿宫内窘迫分为研究组48例(存在胎儿宫内窘迫)及对照组32例(无胎儿宫内窘迫)。所有参检者均行超声检测,比较两组孕妇的大脑中动脉血流动力学指标水平[阻力指数(RI)、搏动指数(PI)、血流速度峰谷比值(S/D)、收缩期峰值血流速度(Vs)、舒张期血流平均速度(Vd)],分析大脑中动脉各血流动力学指标在胎儿宫内窘迫中的诊断价值。结果研究组RI值为(0.65±0.06),PI值为(1.56±0.27),S/D值为(3.41±0.68),Vs为(56.38±2.37)cm/s,Vd为(16.73±1.48)cm/s,均小于对照组的(0.79±0.08)、(1.89±0.31)、(5.28±1.02)、(60.19±2.08)cm/s及(19.68±1.93)cm/s,差异有统计学意义(P<0.05)。RI、PI、S/D、Vs、Vd均可鉴别诊断胎儿宫内窘迫,其中RI及S/D的AUC分别为0.903、0.923,诊断敏感度分别为0.969、0.969,特异度分别为0.729、0.854,PI、Vs、Vd均具有一定的诊断性(P<0.05)。结论超声在胎儿宫内窘迫鉴别诊断中具有较高的临床应用价值,通过监测大脑中动脉血流动力学各参数水平有助于及时判断病情变化情况,为临床诊疗提供可靠的参考,具有较高的临床推广应用价值。Objective To explore the diagnostic value of ultrasonography in monitoring the hemodynamic parameters of middle cerebral artery for fetal distress in utero.Methods The clinical data of 80 pregnant women who underwent labor examination in the Affiliated Hospital of Jiujiang University from May 2021 to July 2022 were retrospectively analyzed and divided into 48 cases in the study group(with fetal distress)and 32 cases in the control group(without fetal distress)according to whether they had fetal distress.All participants underwent ultrasound detection,and compared the levels of mechanical indexes of cerebral arterial blood flow(resistance index[RI],pulse index[PI],peak-valley ratio of blood flow velocity[S/D],maximum systolic velocity[Vs],average diastolic blood velocity[Vd])between the two groups.The diagnostic value of middle cerebral artery hemodynamic indexes in fetal distress was analyzed.Results In the study group,RI value was(0.65±0.06),PI value was(1.56±0.27),S/D value was(3.41±0.68),Vs value was(56.38±2.37)cm/s,Vd value was(16.73±1.48)cm/s.They were lower than those in the control group of(0.79±0.08),(1.89±0.31),(5.28±1.02),(60.19±2.08)cm/s and(19.68±1.93)cm/s,with statistically significant differences(P<0.05).RI,PI,S/D,Vs and Vd were all able to differentiate and diagnose fetal distress.The AUC of RI and S/D were 0.903 and 0.923,the diagnostic sensitivity were 0.969 and 0.969,and the specificity were 0.729 and 0.854,respectively,PI,Vs and Vd were all diagnostic(P<0.05).Conclusion Ultrasound has a high clinical application value in the differential diagnosis of fetal distress in utero.By monitoring the level of the parameters of the blood flow mechanics in the middle arteries of the brain,it can help to determine the changes of the condition in time,provide a reliable reference for clinical diagnosis and treatment,and has a high clinical application value.

关 键 词：胎儿宫内窘迫 彩色多普勒超声 大脑中动脉 血流动力学参数 搏动指数 

分 类 号：R445.1[医药卫生—影像医学与核医学]