CDFI及血流动力学对胎盘早剥诊断的研究

Diagnosis of Abruptio Placentae Using CDFI and Hemodynamics

目的应用彩色多普勒超声检测胎盘早剥患者CDFI及胎盘内动脉和脐动脉血流动力学改变。方法测定110例妊娠妇女(其中正常80例,胎盘早剥30例)胎盘内动脉和脐动脉的血流参数,检测指标包括血流信号特点、收缩期最大速度与舒张末期速度之比(S/D),搏动指数(PI),阻力指数(RI)。结果正常组胎盘CDFI呈星点状、短棒状、条状、树枝状。胎盘内动脉、脐动脉随着孕龄的增加S/D,PI,RI逐渐下降,至36～40周趋于稳定。早剥组CDFI在早剥区域或血肿内无血流信号显示,大面积早剥者胎盘内,脐动脉内均测不到动脉频谱,部分早剥者在其未剥离区域的胎盘内及脐动脉内测及高阻血流。结论二维及CDFI是诊断胎盘早剥的重要手段之一。

Objective To study the CDFI and the hemodynamic changes of placental and umbilical arteries for diagnosing ab ruptio placentae. Methods The placenta and the flow-parameters of placental and umbilical arteries in 80 normal subjects and 30 cases with abruptio placentae were detected on CDFI. The flow signal characteristics, the parameters of systolic maximum velocity/diastolic minimum velocity （S/D）, pulsatility index （PI） and resistance index （RI） were observed and calculated. Results CDFI showed spot-like or stick like flow signals and S/I）, PI and RI in the umbilical artery were decreased with gestational age increasing in normal group, and the indices were stable until 36 40 weeks of gestation. In the abruptio group,no flow signal in the abruptio zone or hernatoma on CI）FI. No flow signal could be detected in the placental or umbilical arteries in most-abruptio cases and high resistant flow signals were showed in the unabruptio zone of partial abruptio cases. Conclusions CDFI was one of the important means to diagnose abruptio placentae and the hemodynamic changes were the important messages to detect partial abruptiao placentae and early abruptio placentae.