经CDFI检查胎儿相关血流参数及其指导意义分析  

Analysis of the results of fetal blood flow parameters examined by CDFI and its guiding significance

作　　者：陈志刚 巢书山 邹运兰 孙娟 卢慧稻 CHEN Zhigang;CHAO Shushan;ZOU Yunan;SUN Juan;LU Huidao(Department of Ultrasound Medicine,Yichun Maternal and Child Health Hospital,Yichun 336099,Jiangxi,China;Department of Ultrasound Medicine,Yichun Second People’s Hospital,Yichun 336028,Jiangxi,China)

机构地区：[1]宜春市妇幼保健院超声医学科,江西宜春336099 [2]宜春市第二人民医院超声医学科,江西宜春336028

出　　处：《中国现代医生》2023年第24期34-37,共4页China Modern Doctor

基　　金：宜春市科技计划项目(JXYC2021KSA031)。

摘　　要：目的回顾性分析95名孕28~42周妇女经彩色多普勒血流成像(color Doppler flow imaging,CDFI)检查胎儿相关血流参数结果,探讨CDFI的临床指导意义。方法选取2019年6月至2022年6月在宜春市妇幼保健院行CDFI检查的50名孕28~42周高危妊娠妇女作为观察组,选择同期行CDFI检查的45名孕28~42周正常妊娠妇女作为对照组。比较两组孕妇的大脑中动脉(middle cerebral artery,MCA)、脐动脉(umbilical artery,UA)和UA/MCA的阻力参数[收缩期峰值血流速度/舒张末期血流速度(systolic/diastolic velocity ratio,S/D)、搏动指数(pulsatility index,PI)、阻力指数(resistance index,RI)]及胎儿脑胎盘血流比(cerebroplacental ratio,CPR),并比较观察组中不同S/D产妇产后的胎儿情况。结果观察组MCA阻力参数均低于对照组,UA和UA/MCA阻力参数均高于对照组(P<0.05);S/D≥2.8组产后胎儿体质量低于S/D<2.8组[(2985.36±321.58)vs.(3562.41±335.74),P<0.001];产后胎儿生长受限发生率(39.29%)、窒息发生率(32.14%)均高于S/D<2.8组(分别为13.64%和4.55%);胎儿出生孕周[(38.12±0.54)周]小于S/D<2.8组[(39.69±0.68)周],P<0.05。结论采用CDFI检查孕28~42周孕妇及胎儿MCA、UA及UA/MCA的阻力参数可有效反映孕妇及胎儿动脉血流变化情况,预测高危妊娠和不良妊娠结局的发生风险,为临床提供一定的指导及参考价值。Objective To explore the results of color Doppler flow imaging(CDFI)examination of fetal blood flow parameters in 95 women at 28-42 weeks of pregnancy,to explore the clinical significance of CDFI.Methods Fifty high-risk pregnant women(28-42 weeks pregnant)who underwent CDFI in Yichun Maternal and Child Health Hospital from June 2019 to June 2022 were selected retrospectively as the observation group,and 45 normal pregnant women(28-42 weeks pregnant)who underwent CDFI in the same period were selected as the control group.The resistance parameters of middle cerebral artery(MCA),umbilical artery(UA)and MCA/UA[the ratio of systolic peak blood flow velocity to end diastolic blood flow velocity(S/D),pulsatility index(PI)and resistance index(RI)],and the cerebroplacental ratio(CPR)were compared between the two groups.And the fetal situation of different S/D parturients of the observation group were compared.Results The MCA resistance parameters in the observation group were lower than those in the control group,while the UA and UA/MCA resistance parameters were higher than those in the control group(P<0.05).The postpartum fetal body mass of the group with S/D≥2.8 was lower than that of the group with S/D<2.8[(2985.36±321.58)vs.(3562.41±335.74),P<0.001],the incidence of postpartum fetal growth restriction(39.29%)and asphyxia(32.14%)were higher than those in the S/D<2.8 group(13.64%and 4.55%);The gestational age of the fetus at birth[(38.12±0.54)weeks]was smaller than that of the S/D<2.8 group[(39.69±0.68)weeks],P<0.05.Conclusion Using CDFI to examine the resistance parameters of MCA,UA and UA/MCA of women and fetuses at 28-42 weeks of gestation can effectively reflect the changes of arterial hemodynamics of pregnant women and fetuses,predict the risk of high-risk pregnancy and adverse pregnancy outcomes.It has certain guidance and reference value in the prevention of high-risk pregnancy and adverse outcomes.

关 键 词：孕晚期 高危妊娠 彩色多普勒血流成像 大脑中动脉 脐动脉 血流参数 

分 类 号：R714[医药卫生—妇产科学]