振动声音刺激后胎儿呼吸运动的类型及其临床意义  

Clinical significance of fetal respiratory movement after vibratory acoustic stimulation test

作　　者：成娅[1] 李幼飞[1] 颜萍[1] 

机构地区：[1]第三军医大学新桥医院妇产科,重庆400037

出　　处：《重庆医学》2004年第4期570-571,共2页Chongqing medicine

摘　　要：目的　通过观察振动声音刺激后胎儿呼吸运动的类型 ,结合临床探讨是否能作为评价胎儿健康的指标。方法　单胎足月妊娠 1 38例作为观察对象 ,正常妊娠 6 5例 ,高危妊娠 73例 ,先常规作产科B超 ,然后取胎儿胸部纵切面 ,在胎儿静止状态下 ,将电子声振器紧贴儿头所在处孕妇腹壁连续 5s声刺激 ,最多声刺 3次 ,间歇 1min ,观察时间 30min。观察胎儿呼吸运动类型。将新生儿Apgar评分≤ 7分和围产儿死亡作为围产结局指标。结果　振动声音刺激下胎儿呼吸运动有 6种 :正常型、不规则型、呃逆型、可疑型、喘息型、无呼吸运动型。正常型、不规则型、呃逆型围产结局良好 ,喘息型单独存在有 2 5 0 % 5minApgar评分≤ 7分 ,与前三型比较有显著差异 (P <0 .0 1 ) ,并有 1例围产儿死亡。无呼吸运动型有 1 0 7%的新生儿Apgar评分≤ 7分 ,与前三型比较无显著差异 (P >0 .0 5 ) ,可疑型 1例。结论　声刺后的正常型、不规则型、呃逆型可作为评价胎儿健康的指标 ,而对于可疑型、喘息型、无呼吸运动是否能作为判断胎儿缺氧还无法定论 ,需加大样本观察。Objective To evaluate the value of the type of fetal respiratory movement after vibratory acoustic stimulation test as marker of fetal health.Methods One hundred and thirty eight term pregnancy women(sixty five were normal pregnancy and seventy three were high risk pregnancy;high risk pregnancy)were enrolled.Their abdominal walls were given a continuously five seconds acoutic stimulation with electric sond vibratory device when the fetal was in silent behavior after a routine obstetric ultrasound examination.Then the fetal respiratory movement was observed by ultrasound in fetal thoracic part longitudinal section for thirty minutes.The Apgar score≤7 and neonate death were studied as perinatal outcome.Results There were six types of fetal respiratory movement after vibratory acoustic stimulation test:normal form,non regulate form,singultus form,suspected form,gasping form and non respiratory movement form.The perinatal outcome of the former three forms were well.The rate of five minute Apgar score ≤7 in gasping from(25.0%) with one neonate death was significant statistically than that of the former three forms( P < 0.01 ).There was no statistical significant defference between non rspiratory movement form.Which was 10.7% and the former three forms.Conclusion Normal form,non regulate form and singultus form could be acted as marker of fetal health,but suspected form,and non respiratory movement form couldn′t be accepted to judge fetal hypoxia,and clinician should pay more attention to gasping form.

关 键 词：声刺激 胎儿呼吸运动 超声学 

分 类 号：R71415[医药卫生—妇产科学]