超声引导下疤痕子宫羊膜腔灌注的临床应用

Clinical application of amnioinfusion in scared uterus under guidance of ultrasound

目的探讨在超声引导下疤痕子宫羊膜腔灌注的临床应用价值。方法48例疤痕子宫行超声引导下羊膜腔灌注术,通过分析灌注前后雌三醇、胎盘生乳素、脐动脉血流变化等指标研究胎盘功能,通过灌注前后羊水指数变化评价治疗羊水过少的效果。结果羊水过少的病例经羊膜腔灌注术后羊水指数显著增加,治疗前4.2±2.1cm,治疗后6.8±3.8cm,P<0.05;胎盘评分增加,治疗前8.1±2.4,治疗后10.1±3.2,变异减速治疗后消失,治疗前后有显著性差异。结论疤痕子宫在超声引导下进行羊膜腔灌注可提高羊水指数,增加胎监评分,缓解变异减速,降低胎儿窘迫的发生。

Objective To investigate the clinical application of amnioinfusion in scared uterus under guidance of ultrasound. Methods Amnioinfusion was performed on 48 patients who had scared uterus. Changes of estriol, HPL and the umbilical arterial S/D and RI were observed to assess the function of placenta. The therapeutic effects were evaluated by measuring the changes of AFI and the results of FHR. Rtrsults After amnioinfusion, the AFI increased prominently from 4.2 ± 2.1 cm to 6.8 ± 3.8 cm in oligohydramnios （ P 〈 0.05） ; the scores of FHR electronic montoring increased from 8.1 ± 2.4 to 10.1 ± 3.2; Variable deceleration disappeared after the treatment. Conclusion in scared uterus with ultrasonic monitoring is safe. The treatment can increase the scores of FHR electronic monitoring, alleviate variable deceleration and decrease the incidence of fetal distress in oligohydramnios.