胎儿血氧饱和度监测在产程中的应用及临床意义

Significance and application of fetal oxygen saturation monitoring in labor.

目的研究胎儿血氧饱和度(FSaO2)监测方法在产程中的应用,探讨其对诊断胎儿窘迫、新生儿窒息方面的临床意义。方法监测产程不同时段FSaO2值,监护并记录胎心率-宫缩曲线图(CTG),观察羊水粪染情况,分娩后脐血血气分析,并观察新生儿Apgar评分。结果①FSaO2值在CTG正常及CTG异常时其差异有极显著性意义;②羊水清亮者FSaO2值与羊水粪染Ⅱ～Ⅲ度者FSaO2值比较,差异有显著性意义;③FSaO2值<30%作为诊断标准预测胎儿酸中毒、新生儿窒息,其准确性高于CTG、羊水粪染观测方法。结论FSaO2能较为准确地反应胎儿氧合状态及酸碱平衡状态,FSaO2及CTG联合使用,结合羊水性状观察能更为准确地预测胎儿、新生儿情况。

Objective To study the application of the fetal blood oxygen saturation （FSaO2） in labor. FSaO2 monitoring and amniotic fluid detecting were compared to investigate the accuracy of FSaO2 monitoring in the diagnosis of fetal distress and apnoea neonatorum. Methods The FSaO2 were monitored during different stages of labor. The average value of FSaO2 in the first and second stage of labor were studied and compared; CTG were recorded by the electronic fetal monitoring; The amniotic fluid status were observed; Apgar scores were recorded. Results ①The average value of FSaO2 in normal CFG is higher than it in abnormal significantly. ②The average value of FSaO2 it, normal is higher than in Ⅱ °- Ⅲ ° meconium-stained amniotic fluid significantly. ③As a diagnosis standard, FSaO2 values less than 30% represent an acidotic status, its accuracy in predicting fetal distress and apnoea neonatorum is better than monitoring CTG or detecting amnion fluid status. Conclusion FSaO2 can represent the situation of the acid-base balance and oxygenation of fetus accurately. The combined application of monitoring FSaO2, CTG and detecting amnion fluid status may be an efficient and accurate method to predict fetal, distress, acidosis and apnoea neonatorum.