彩色多普勒检测胎儿动脉血流动力学指标预测胎儿宫内缺氧的价值

Predicting neonatal hypoxia by dectecting valuable fetus blood flow hemodynamics index which were measured with color Dopple ultrasound

目的:探讨彩色多普勒选择胎儿最佳动脉血流动力学指标预测胎儿宫内缺氧的价值。方法:运用彩色多普勒检测60例正常晚孕(正常组)和32例临床判断为宫内缺氧胎儿(缺氧组)的肾动脉(RA)、脐动脉(UmA)、大脑中动脉(MCA)的收缩期末速度(Vs)、舒张期末速度(Vd)、搏动指数(PI)、阻力指数(RI)及Vs/Vd值,记录各数值并与围生儿结局进行对比分析。结果:缺氧组胎儿RA、UmA、MCA的各项指标与正常组均有较明显变化,其中以缺氧组胎儿RA的R、UmA的Vs/Vd值及MCAPI/RAPI值变化明显,与正常组差异均有统计学意义(P<0.01),联合3项指标检测,预测胎儿宫内缺氧的敏感性达95%,特异性达100%,其余几项指标的敏感性及特异性较低。结论:联合运用RA RI、UmA Vs/Vd、MCA PI/RA PI 3项指标对预测胎儿宫内缺氧有一定参考价值。

Objective：To evaluate the value of color Dopple ultrasound in predicting neonatal hypoxia, and choose the most valuable blood flow hemodynamics for clinical work. Methods： Total of 92 pregnant women with gestion age 32 - 42 weeks were divided into two groups ：60 cases were normal and 32 cases with hypoxia were diagnosed by clinical manifestation. All of them were examined by prenatal color Dopple ultrasound. The hemodynamics parameters, included Vs （ systolic peak velocity ） , Vd （ end diastolic velocity） , Vs/Vd, PI （pulsatility index） and RI（ resistance index） of fetal UmA （umbilical artey）, MCA （middle cerebral artery） and RA （renal artery） were measured, recorded all outcomes and compared with neophew. Results：There were significant differences in several hemodynamics parameters of MCA, UMA, RA between normal group and hypoxia group, especially in RI （ P 〈 0.01 ） in RA, Vs/Vd （ P 〈 0.01 ） in UmA and MCA PVRA PI（P 〈 0.01 ）. Conclusions ：RA RI combined with UMA Vs/Vd and MCA PI/RA PI were valuable to predict fetal hypoxia.