彩色多普勒超声检测胎儿脐血流在宫内窘迫诊断中的临床价值

Clinical application value of color Doppler ultrasonic examination on fetal umbilical cord blood flow in diagnosis of fetal distress in uterus

目的探讨彩色多普勒超声检测胎儿脐血流对宫内窘迫诊断的临床价值,分析宫内窘迫胎儿脐血流指数特征。方法采用99SOD-VI多普勒超声脐动脉血流分析仪检测300例分娩孕妇脐动脉收缩末期峰值(S)、舒张末期峰值(D)、搏动指数(PI)和阻力指数(RI),比较宫内窘迫胎儿及无宫内窘迫胎儿脐血流指数,以及同一时期S/D值。结果 S/D≥3.0孕妇(48例)宫内窘迫发生率83.33%,<3.0孕妇(252例)宫内窘迫发生率1.98%,差异有统计学意义(P<0.05)。发生宫内窘迫的胎儿临产前脐血流S/D值与无宫内窘迫胎儿差异无统计学意义(P>0.05),潜伏期、活跃期和第2产程S/D值开始呈逐渐上升趋势,潜伏期S/D、PI和RI值均显著高于无宫内窘迫的胎儿(P<0.05),而无宫内窘迫的胎儿无明显变化,二者比较差异均有统计学意义(P<0.05)。结论彩色多普勒超声检测胎儿脐血流能有效筛查胎儿宫内窘迫,有利于早期诊断和治疗,值得临床推广应用。

Objective To investigate the clinical value of color fetal umbilical cord blood flow in diagnosis of fetal distress in uterus, and to analyze the features of umbilical cord blood flow indexes in distress in uteruses. Methods 300 pregnant women were se- lected. The peak values of umbilical arteries at end-systole （S） ,the peak values of umbilical arteries at end-diastole （D） ,the pulsation indexes （PI） and the resistance indexes （RI） were determined. Results The incidence of distress in uterus of the observation group （S/D≥3.0） was 83.33% ,that of the control group （S/D〈3. 0） was 1.98% ,and the difference between the two groups was statistically significant （P 〈 0.05）. S/D, PI and RI values of fetuses under distress in uteruses were all significantly higher than those of the fetuses without distress in uteruses, and the differences were all statistically significant （P 〈 0.05 ）. The differences in umbilical cord blood flow S/D values before birth between the two groups had no statistical significance （P 〉 0. 05 ） ;in latent phase, active phase and the second stage of labor,the umbilical cord blood flow S/D values of fetuses under distress in uteruses were gradually increased, while those of the fetuses without distress in uteruses changed insignificantly, and the differences between the two groups were statistically sig- nificant （P 〈 0. 05 ）. Conclusion Color Doppler ultrasonic examination on fetal umbilical cord blood flow can effectively screen fetal distress in uterus, is beneficial to early diagnosis and therapy, can promote the rehabilitation of the sick babies, and consequently is wor-thy of clinical generalization and application.