胎儿脐动脉、大脑中动脉及腹主动脉的血流频谱与脐动脉血气相关性的研究

The Relationship Between Flow Velocity Waveforms of Umbilical and Fetal Middle Cerebral Arteries and Abdominal Aorta and Cord Blood Gas Values

本文对３２例足月单胎正常妊娠拟行择期剖宫产的初孕妇，于术前３０小时内，以彩色超声多普勒测定胎儿脐动脉（ＵＡ），大脑中动脉（ＭＣＡ）及腹主动脉（ＡｂＡｏ）的血流频谱．即血流阻力指数（ＲＩ），搏动指数（ＰＩ），收缩期峰值（Ｓ）与舒张末期值（Ｄ）的比值（Ｓ／Ｄ）。并于剖宫术胎儿娩出后取脐动、静脉血、测定ＰＨ、ＰＣＯ２及ＰＯ２，观察各种动脉血流频谱与脐血血气间相关性。结果表明：ＵＡ—ＲＩ与脐动脉血气ＰＨ、ＰＣＯ２呈显著的负相关（Ｐ＜０．０１及Ｐ＜０．０５），ＭＣＡ—ＲＩ与脐动脉ＰＨ值呈负相关（Ｐ＜０．０５），与ＰＣＯ２呈明显正相关，（Ｐ＜０．０１），ＡｂＡｏ－ＲＩ与脐动脉血气三项虽呈负相关，但不显著（Ｐ＞０．０５）。提示：产前监测ＵＡ及ＭＣＡ血流频谱，可间接了解胎儿的内环境血气及酸碱情况，能及早的诊断胎儿宫内安危状况。

Umbilical arlery(UA)and felal middle cerebral artery(MCA)and abdominal aorta(AhA.) flow velocity waveforms were obtained from 32 fetues just prior to elective cesarean Section at 37-- 41 weeks of gestation and the resistance index(RI)was calculaled for each waveforms. Cord blood Samples were obtained from both the umbilical artery' and the vein at cesarean section and the blood gas values were measured immediately the coefficients of correlation between the cord blood gas values and the resistance index were obtained. l. UA-RI had a significant negative correlation with UA-PH and Pco2(p<0 01).2.MCA -BI had a significant negative Correlation with UA-PH(P<0.05)and a positive correlation with PcoZ(prO.of ).3.AhAo-RI had a negaive correlation wilh UA-PH. Pco2. pO2(P>0.05).4.The best correlation was found in theUA -- RI and the MCARI,UA-RI and MCA-RI had a closer correlation with umbilical artirial blood gas-values. Doppler study of fetus flow velocity waveforms(F. V. W)would be useful melhod in diagnosing fetal distress in the uterus.