对脐血流S/D比值异常患者的临床研究

A clinical study on abnormal S/D ratio of umbilical artery flow

目的探讨应用彩超诊断仪分析脐血流在监护胎儿宫内安危的临床价值。方法检测3020例妊娠28～42周孕妇的胎儿脐动脉血流频谱，测定收缩期血流速度峰值与舒张期血流速度之比，分析异常组（收缩期峰值与舒张期低值之比≥3）388例与正常组（收缩期峰值与舒张期低值之比〈3）2632例胎儿的妊娠结局及分娩方式。结果异常组的脐绕颈、中及重度妊娠高血压疾病、胎儿窘迫和胎儿宫内生长受限等的发生率明显高于正常组，u值分别为7．46、3．58、3．45、4．12、3．46、2．96、6．89，均P〈0．01；且两组分娩方式也有明显差异，u值分别为6．51、3．46、2．74，均P〈0．01。结论高危胎儿脐血流缓慢，影响胎儿-胎盘血供，表现为收缩期峰值与舒张期低值之比异常，且直接影响其分娩方式。

Objective To evaluate value of systolic peak/diastolic peak（S/D） ratio of umbilical artery flow in Doppler ultrasonography in predicting fetal hypoxia in pregnancy. Methods 3 020 pregnant women with 28～42 weeks of gestation were examined with color Doppler for frequency spectrum of umbilical artery flow and S/D ratio. 388 pregnant women with abnormal S/D ratio of≥3 were included in the study group and 2 632 pregnant women with S/D 〈 3 were included in the control group. The pregnancy outcomes and delivery patterns were analyzed. Results The incidences of umbilical cord around fetal neck, moderate and severe hypertensive disorder complicating pregnancy, fetal distress, intrauterine fetal growth retardation（FGR） were significantly higher in the study group than those in the normal control group（ u = 7.46, 3.58, 3.45, 4.12, 3.46, 2.96, 6.89 respectively, all P 〈 0.01 ）, and in delivery patterns there was significant difference between the two groups（ u = 6.51, 3.46, 2.74 respectively, all P 〈 0.01. Conclusion The fetal umbilical artery blood flow is decreased and this affect blood supply of the fetus and placenta, presenting with an abnormal S/D ratio, and the delivery patterns of the pregnant women.