胎儿大脑中动脉、脐动脉血流指标水平与脐血血气分析结果的相关性分析  

Analysis of the correlation of the blood flow indexes of fetal middle cerebral artery and umbilical artery with the results of umbilical cord blood gas analysis

作　　者：张莉 林玲[1] 罗怀英 饶福光 ZHANG Li;LIN Ling;LUO Huai-ying(Department of Neonatology,Longgang District Maternal and Child Health Hospital(Longgang Maternal and Child Clinical College of Shantou University Medical College),Shenzhen 518100,China)

机构地区：[1]深圳市龙岗区妇幼保健院(汕头大学医学院龙岗妇幼临床学院)新生儿科,518100 [2]深圳市龙岗区妇幼保健院(汕头大学医学院龙岗妇幼临床学院)妇产科,518100 [3]深圳市龙岗区妇幼保健院(汕头大学医学院龙岗妇幼临床学院)儿科,518100

出　　处：《中国实用医药》2024年第6期81-84,共4页China Practical Medicine

摘　　要：目的 分析胎儿大脑中动脉、脐动脉血流指标水平与脐血血气分析结果的相关性。方法 选取90例孕产妇,根据是否出现胎儿窘迫分为对照组(未发生胎儿窘迫,74例)和观察组(发生胎儿窘迫,16例)。于孕产妇孕晚期实施常规超声检查,并在新生儿出生后进行脐血血气分析检测。比较两组胎儿大脑中动脉及脐动脉血流指标[舒张期血流速度(VD)、收缩期血流速度(VS)、搏动指数(PI)、阻力指数(RI)及收缩期峰值血流速度与舒张末期血流速度之比(S/D)]水平,胎儿脐血血气指标[二氧化碳分压(PCO_(2))、氧分压(PO_(2))、碱剩余(BE)、p H值]水平;分析胎儿大脑中动脉及脐动脉血流指标水平与脐血血气指标水平相关性。结果 对照组大脑中动脉VD、VS、PI、RI及S/D分别为(20.17±2.01)cm/s、(68.31±2.39)cm/s、(1.48±0.28)、(0.74±0.18)、(4.45±0.74),脐动脉VD、VS、PI、RI及S/D分别为(16.64±4.25)cm/s、(61.02±4.21)cm/s、(0.74±0.21)、(0.59±0.10)、(3.24±0.72);观察组大脑中动脉VD、VS、PI、RI及S/D分别为(15.04±2.03)cm/s、(66.25±2.37)cm/s、(1.25±0.31)、(0.55±0.14)、(3.22±0.85),脐动脉VD、VS、PI、RI及S/D分别为(12.25±3.89)cm/s、(57.26±4.30)cm/s、(1.02±0.20)、(0.75±0.14)、(2.25±0.64)。与对照组相比,观察组胎儿大脑中动脉VD、VS、PI、RI及S/D更低,脐动脉VD、VS、S/D更低,脐动脉PI、RI更高(P<0.05)。观察组胎儿p H(7.15±0.03)、PO_(2)(23.24±4.29)mm Hg(1 mm Hg=0.133 k Pa)及BE(-7.24±1.41)mmol/L低于对照组的(7.26±0.02)、(28.11±4.36)mm Hg、(-6.01±1.45)mmol/L,PCO_(2)(61.33±2.37)mm Hg高于对照组的(45.35±2.31)mm Hg(P<0.05)。胎儿大脑中动脉VD、VS、PI、RI、SD与脐血p H、PO_(2)、BE呈正相关,与脐血PCO_(2)呈负相关(P<0.05)。胎儿脐动脉VD、VS、SD与p H、PO_(2)、BE呈正相关,与PCO_(2)呈负相关(P<0.05),脐动脉血PI、RI与p H、PO_(2)、BE呈负相关,与PCO_(2)呈正相关(P<0.05)。结论 胎儿大脑中动脉、脐动脉血流指�Objective To analyze the correlation of the blood flow indexes of fetal middle cerebral artery and umbilical artery with the results of umbilical cord blood gas analysis.Methods 90 pregnant women were selected and divided into a control group(no fetal distress,74 cases)and an observation group(fetal distress,16 cases)according to whether there was fetal distress.Routine ultrasound examination was performed in the third trimester of pregnancy and umbilical cord blood gas analysis was performed after birth.Comparison was made on blood flow indexes[diastolic velocity(VD),systolic velocity(VS),pulsation index(PI),resistance index(RI)and the ratio of peak systolic velocity to end-diastolic velocity(S/D)]of fetal middle cerebral artery and umbilical artery were compared between the two groups,as well as the blood gas index[partial pressure of carbon dioxide(PCO_(2)),partial pressure of oxygen(PO_(2)),base excess(BE),pH value]of fetal cord blood.The correlation of the blood flow indexes of fetal middle cerebral artery and umbilical artery with the results of umbilical cord blood gas analysis was analyzed.Results In the control group,the values of VD,VS,PI,RI and S/D of middle cerebral artery were(20.17±2.01)cm/s,(68.31±2.39)cm/s,(1.48±0.28),(0.74±0.18)and(4.45±0.74),and those of umbilical artery were(16.64±4.25)cm/s,(61.02±4.21)cm/s,(0.74±0.21),(0.59±0.10)and(3.24±0.72).In the observation group,the values of VD,VS,PI,RI and S/D of middle cerebral artery were(15.04±2.03)cm/s,(66.25±2.37)cm/s,(1.25±0.31),(0.55±0.14)and(3.22±0.85),and those of umbilical artery were(12.25±3.89)cm/s,(57.26±4.30)cm/s,(1.02±0.20),(0.75±0.14)and(2.25±0.64).Compared with the control group,the values of VD,VS,PI,RI and S/D of fetal middle cerebral artery in the observation group were lower;VD,VS and SD of umbilical artery were lower,while the values of PI and RI were higher(P<0.05).The observation group had fetal pH of(7.15±0.03),PO_(2) of(23.24±4.29)mm Hg(1 mm Hg=0.133 kPa)and BE of(-7.24±1.41)mmol/L,which were lower than(

关 键 词：大脑中动脉 脐动脉 血流指标 脐血血气分析 胎儿窘迫 

分 类 号：R714.5[医药卫生—妇产科学]