河北医科大学学报

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多普勒超声预测羊水过少胎儿窘迫的价值#br#

  

  1. 1.河北北方学院附属第一医院超声医学科，河北 张家口 075000；2.河北北方学院附属第一医院产科，
    河北 张家口 075000；3.河北北方学院附属第一医院儿科，河北 张家口 075000
  • 出版日期:2020-04-25 发布日期:2020-05-15
  • 作者简介:罗兵（1985-），女，四川都江堰人，河北北方学院附属第一医院主治医师，医学硕士，从事超声医学诊断研究。
  • 基金资助:
    张家口市市级科技计划项目（1921036D）

Value of doppler ultrasonography in predicting fetal distress with oligohydramnios#br#

  1. 1.Department of Ultrasonics, the First Affiliated Hospital of Hebei North University, Zhangjiakou
    075000, China; 2.Department of Obstetrics, the First Affiliated Hospital of Hebei North University,
    Zhangjiakou 075000, China; 3.Department of Pediatrics, the First Affiliated Hospital of
    Hebei North University, Zhangjiakou 075000, China
  • Online:2020-04-25 Published:2020-05-15

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摘要： ［摘要］
 目的 探讨胎儿脐动脉(umbilical artery,UA)、大脑中动脉(middle cerebral artery,MCA)、肾动脉(renal artery,RA)血流阻力指标及比值预测羊水过少胎儿窘迫的价值。
 方法 选取孕周37~41+6周孕妇283例。根据羊水量分为羊水量过少胎儿83例和羊水量正常胎儿200例，羊水量过少胎儿根据胎儿有无窘迫分为窘迫组19例及无窘迫组64例。应用脉冲多普勒技术获取各组胎儿UA、MCA、RA血流频谱，测量动脉阻力指数(resistance index,RI)及搏动指数(pulsation index,PI)，计算RIUA/MCA、PIUA/MCA、RIRA/MCA和PIRA/MCA。记录胎儿出生后1 min Apgar评分。
 结果 窘迫组UA和RA的PI、RI明显高于对照组和无窘迫组，MCA的PI、RI明显低于对照组和无窘迫组，RIUA/MCA、PIUA/MCA、RIRA/MCA及PIRA/MCA均明显高于对照组和无窘迫组(P＜0.01)；对照组和无窘迫组上述指标差异均无统计学意义(P＞0.05)。
 结论 监测胎儿UA、MCA、RA阻力指标及比值可预测羊水过少胎儿窘迫，提示临床及时治疗。

关键词: 胎儿窘迫, 羊水过少, 超声检查, 多普勒

Abstract: ［Abstract］Objective〖HTSS〗To explore the value of blood flow resistance index and ratio of fetal umbilical artery(UA), middle cerebral artery(MCA) and renal artery(RA) in predicting fetal distress with oligohydramnios.
 〖WTHZ〗Methods〖HTSS〗Two hundred and eighty-three pregnant women with gestational weeks of 37 to 41+6 weeks were selected. According to the amount of amniotic fluid, all the cases were divided into oligohydramnios group(83 cases) and control group(200 cases). Meanwhile, fetuses in oligohydramnios group were divided into distress group(n=19) and non-distress group(n=64) according to fetal distress. Among all the fetus, the blood flow spectrum of UA, MCA and RA were obtained by pulsed Doppler technique, and the arterial resistance index(RI) and pulsation index(PI) were measured to calculate RIUA/MCA, PIUA/MCA, RIRA/MCA and PIRA/MCA. Apgar score was recorded at 1 min after birth.
 〖WTHZ〗Results〖HTSS〗The PI and RI of UA and RA in distress group were significantly higher than those in control group and non-distress group, PI and RI of MCA were significantly lower than those in control group and non-distress group, and the levels of RIUA/MCA, PIUA/MCA, RIRA/MCA and PIRA/MCA in distress group were significantly higher than those in control group and non-distress group(P＜0.01). While there were no significant differences in the above-mentioned indexes between control group and non-distress group(P＞0.05).
 〖WTHZ〗Conclusion〖HTSS〗Monitoring the resistance index and ratio of fetal UA, MCA and RA can predict fetal distress with oligohydramnios and indicate clinical treatment timely.

Key words: fetal distress, oligohydramnios, ultrasonography, Doppler

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