非Ⅲ级胎监胎心率基线变异消失时长与频率变化规律  

Duration and frequency pattern of baseline fetal heart rate variability loss in non-categoryⅢfetal heart rate monitoring

作　　者：欧有良[1] 周燕莉[1] 盛超[1] 吴瑜瑜[1] 都萍萍[1] OU You-liang;ZHOU Yan-li;SHENG Chao;WU Yu-yu;DU Ping-ping(Department of Obstetrics and Gynecology,Nanfang Hospital,Southern Medical University,Guangzhou 510515,Guangdong,China)

机构地区：[1]南方医科大学南方医院妇产科,广东广州510515

出　　处：《广东医学》2024年第8期1004-1010,共7页Guangdong Medical Journal

基　　金：广东省卫健委适宜技术推广项目(SYWSJSTG006)。

摘　　要：目的探索非Ⅲ级胎监胎心率基线变异消失时长与频率变化规律。方法随机选取2020年1月至2023年5月规律产检并住院分娩的宫内单活胎孕妇2000例,依孕期是否有高危因素,分为高危组与低危组。孕28周开始行胎心监护,每天一次直至分娩,观察其基线变异消失时长与频率变化。结果孕28~40^(+6)周胎心率基线变异消失时长中位数:低危组为5.45~12.40 s/次、高危组为5.95~12.00 s/次;频率中位数:低危组为2.00~3.00次/20 min、高危组为2.00~3.00次/20 min。重复测量方差分析示:两组间胎心率基线变异消失时长与频率:时间效应、组间效应、交互效应差异均有统计学意义(P<0.05)。胎心率基线变异消失事件前12 h内:胎心率基线变异消失时长[M(P_(25),P_(75))]低危组为12.40(11.80,13.50)s/次,高危组为12.70(11.80,13.50)s/次;低危组与高危组胎心率基线变异消失频率[M(P_(25),P_(75))]均为4.00(3.00,5.00)次/20 min;重复测量方差分析示:两组间胎心率基线变异消失时长时间效应有统计学意义(P<0.05)。结论非Ⅲ级胎监胎心率基线变异消失是胎儿心率生理不成熟的表现,也受监测临床环境影响,胎儿越危险,其变异消失持续时间越长,当变异消失时长≥10 s/次,频率≥3次/20 min提示胎心率基线变异消失事件,需及时干预。Objective To investigate the duration and frequency patterns of baseline fetal heart rate(FHR)variability loss in non-Category Ⅲ fetal heart rate monitoring.Methods A random selection of 2000 pregnant women with regular antenatal care and hospital deliveries from January 2020 to May 2023,each carrying a singleton fetus,were included in the study.Participants were categorized into high-risk and low-risk groups based on the presence of high-risk factors.Starting from 28 weeks of gestation,daily fetal heart rate monitoring was conducted until delivery.The duration and frequeney of baseline FHR variability loss were observed and recorded.Results In 28-40^(+6)weeks of pregnaney,the median duration of baseline FHR variability loss was 5.45-12.40 seconds per episode in the low-risk group and 5.95-12.00 seconds per episode in the high-risk group.The median frequency was 2.00-3.00 episodes per 20 minutes in the low-risk group and 2.00-3.00 episodes per 20 minutes in the high-risk group.Repeated measures AN0-VA indicated significant differences between groups in terms of time effect,group effect,and interaction effect for the duration and frequency of baseline FHR variability loss(P<0.05).Within 12 hours before the baseline FHR variability loss event,the median(interquartile range)duration of baseline FHR variability loss was 12.40(11.80,13.50)seconds per episode in the low-risk group and 12.70(11.80,13.50)seconds per episode in the high-risk group.The median(interquartile range)frequency of baseline FHR variability loss in both groups was 4.00(3.00,5.00)episodes per 20 minutes.Repeated measures ANOVA showed a significant time effect for the duration of baseline FHR variability loss between the two groups(P<0.05).Conclusion The loss of baseline FHR variability in non-category Ⅲ fetal heart rate monitoring reflects physiological immaturity of fetal heart rate and is influenced by clinical monitoring conditions.Longer durations of variability loss and higher frequencies are associated with increased fetal risk.A duration

关 键 词：非Ⅲ级胎监 胎心率基线变异消失 时长 频率 胎心率基线变异消失事件 

分 类 号：R442.9[医药卫生—诊断学] R714.7[医药卫生—临床医学]