B超介导下经皮脐静脉穿刺术出现胎心减慢的临床分析

Clinical analysis of fetal bradycardia after B ultrasound-guided percutaneous umbilical vein puncture

目的:探讨B超介导下经皮脐静脉穿刺术出现胎心减慢的原因。方法:对2003年1月～2009年4月在我院行B超介导下经皮脐静脉穿刺术的775例孕妇的临床资料进行回顾性分析。结果:在755例B超介导下经皮脐静脉穿刺术中,出现胎心减慢28例(3.71%)。28例胎心减慢病例中,因FGR行脐静脉穿刺术3例(10.71%),因单脐动脉行脐静脉穿刺术3例(10.71%),因羊水过多行脐静脉穿刺术4例(14.29%),胎盘渗血9例(32.14%),脐带渗血21例(75.00%)。结论:因FGR、单脐动脉、羊水过多原因行B超介导下经皮脐静脉穿刺术,出现胎心减慢的几率较高,宜选择在孕18～28周进行穿刺,缩短手术时间,尽量减少胎盘及脐带渗血。降低B超介导下经皮脐静脉穿刺术出现胎心减慢的几率,使此项介入性诊断技术更有效、安全地应用于临床。

Objective：To explore the factors of fetal bradycardia after B ultrasound-guided percutaneous umbilical vein puncture. Methods：Clinical data of 775 cases of pregnant women by B ultrasound-guided percutaneous umbilical vein puncture from January 2003 to April 2009 in our hospital were retrospectively analyzed. Results：Among 755 patients,28 cases of patients （3.71%） occurred fetal bradycardia. Of these 28 patients,the cases of the patients who were performed percutaneous umbilical vein puncture because of FGR,single umbilical artery,hydramnion,placenta errhysis,umbilical errhysis were 3 （10.71%）,3 （10.71%）,4 （14.29%）,9 （32.14%）,21 （75.00%） respectively. Conclusion：The rate of fetal bradycardia is high after B ultrasound-guided percutaneous umbilical vein puncture with FGR,single umbilical artery and hydramnion,the operation should be performed between 18 weeks and 28 weeks,to reduce time and placenta errhysis or umbilical errhysis. So that we would decrease the chance of fetal bradycardia in those pregnancies after B ultrasoundguided percutaneous umbilical vein puncture,and make it a safe and effective procedure for prenantal diagnosis.