彩超联合检测胎儿脐动脉、大脑中动脉及肾动脉血流动力学变化的临床价值

Clinical Value of Monitoring Fatal Blood Flow Hemodynamics by the Technology of Color Doppler Ultrasonography

目的应用彩色多普勒超声技术联合检测胎儿脐动脉（Umbilical Artery，UA）、大脑中动脉（Middle Cerebral Artery，MCA）及。肾动脉（Renal Artery，RA）血流动力学指标，分析比较其预测胎儿宫内缺氧和评价围产儿结局的临床应用价值。方法选取晚期正常妊娠孕妇95例（正常妊娠组）和高危妊娠孕妇45例（高危妊娠组），采用彩色多普勒超声技术检测两组胎儿UA、MCA及RA的血管收缩期峰值速度（s）与舒张末期流速（D）比值（S／D）、阻力指数（Resistant Index，RI）及脉动指数（Pulsatility Index，PI），比较两组间各阻力指标的差异性，并将以上检测值与围产儿缺氧指标进行比较。结果高危组胎儿脐动脉各阻抗指标均高于正常妊娠组（P〈0．01）；大脑中动脉各阻抗指标均低于正常妊娠组（P〈0．01）；肾动脉各阻抗指标均高于正常妊娠组，（其中PI及RI值P〈0．01，S／D值P〈0．05）。结论产前联合检测胎儿脐动脉，大脑中动脉及。肾动脉血流指标，可以较为准确地了解胎儿颅脑血循环及胎盘循环状态并预测胎儿宫内缺氧。

Objective Monitoring fatal Umbilical artery（UA）, Middle cerebral artery（MCA） and renal artery （RA）by the technology of color Doppler ultrasonography to predict fetal intrauterine hypoxia. Methods Color Doppler was used to examine fatal UA, MCA and RA blood flow waveforms in two groups： normal pregnancy （95cases） and high risk groups（45cases）.The resistant index（RI）, pulsatility index（PI） and peak systolic to end diastolic ratio（S/D） were evaluated. All these results were compared with some clinical index of hypoxia. Results The RI,PI and S/D of fetal RA and UA in the high risk group were significantly higher than those in normal group（P〈0.01）and the RI,PI and S/D of MCA in the high risk group were lower than those of the normal group （ P〈0.05）.Conclusions Monitoring MCA,UA and RA blood flow resistance could supply important information about fetal brain and fetal placenta circulation, and could predict fetal intrauterine hypoxia.