多普勒超声对妊娠自然终止患者血流动力学变化的研究

Study on the Hemodynamics Changes of Patients with Pregnancy Failure by Means of Doppler Ultrasound

目的应用多普勒超声评价妊娠自然终止患者子宫动脉和卵巢动脉的血流动力学的变化。方法选择在北京妇产医院就诊的273名患者进行超声检查,其中正常早期妊娠者156例,自然妊娠终止患者117例(胚胎停止发育52例,无胚胎妊娠65例)。应用经腹超声测量孕妇双侧子宫动脉上行支和卵巢动脉,并对数据进行统计学分析。结果妊娠自然终止患者优势侧和非优势侧子宫动脉的搏动指数(pulse index,PI)、阻力指数(resistant index,RI)、收缩期最大血流速度与舒张期最小血流速度比值(ratio between the peak of systolic velocity and the end of diastolic velocity S/D)测量值均明显低于正常早期妊娠妇女,差异均有统计学意义。而胚胎停止发育和无胚胎妊娠患者之间差异无统计学意义。卵巢动脉血流动力学变化在3组之间差异无统计学意义。结论子宫动脉上行支的PI、RI值可用来辅助判断妊娠是否终止,当优势侧子宫动脉上行支的PI、RI值明显减低时(PI<1.80,RI<0.77),提示妊娠终止的可能性极大。

Objective To investigate the hemodynamic changes of the pregnancy failure by Doppler ultrasound. Methods 273 cases were examined with ultrasound, there were 156 cases of normal early pregnancy, 52 cases pregnancy failure and 65 cases anembryonic pregnancy. The bilateral arteries of uterus and ovary were measured by trans abdominal color and pulsed Doppler. The data of the blood flow were analysed by statistically. Results The measurement of the pulse index（PI）, the resistant index （RI） and the ratio between the peak of systolic velocity and the end of diastolic velocity（S/D） of dominant and non-dominant uterus artery in pregnancy failure were much lower than that of normal early pregnancy. There was significant statistic difference in the PI, RI and S/D between them. And there were similar ities between the pregnancy failure and anembryonic pregnancy, with no statistic difference between them. No significant difference was found between the pregnancy failure and normal early pregnancy in terms of ovarial artery measurement. Conclusion The change of PI and RI in uterus artery could be used to evaluate the outcome of the pregnancy. When the PI and RI of the dominant uterus artery are lower than 1.80 and 0.77 respectively, the risk of the pragnancy failure is higher than normal.