羊水污染胎儿血流动力学变化与围产儿的结局

目的研究羊水污染的胎儿脐动脉(UA)、大脑中动脉(MCA)、肾动脉(RA)的血流动力血学,即收缩期血流速度峰值/舒张期血流速度峰值(S/D)值、搏动指数(PI)、阻力指数(RI)值的变化和它们之间的关系及其围产儿的结局。方法使用彩色多普勒超声显像(CDI)技术对160例羊水不同程度污染的胎儿和50例无羊水污染的胎儿的UA、MCA、RA的S/D值、PI、RI进行监测,分别比较其正常值与异常值,预测围产儿的预后。结果羊水Ⅲ°污染的胎儿血流动力学S/D、PI、RI值异常者和围产儿预后不良率明显高于正常组和羊水Ⅰ°、Ⅱ°污染组,具有统计学意义(P<0.05)。结论产前检测胎儿的UA、MCA、RA的血流动力学S/D、PI、RI值,结合羊水污染程度,对围产儿预后的预测有极其重要的临床价值。

Objective The featl hermodynamics with amniotic fluid contamination of fetal umbilical artery（UA）,middle cerebral artery （MCA）,and renal artery （RA）that is changes of peak veloc of blood flow in systole per diastole（S/D）,pulsation index（PI）,resistance index（RI）,and their correlations and the outcomes of perinatal fetus were studied using color Doppler ultracsonography （CDI）. Methods Color Doppler Flow Inmage （CDI） was used todestect S/D,PI,RI of UA,MCA,RA,in 160 cases of fetus with different degrees of amniotic fluid contamination paired with 50normal fetus.The comparisions of their normal Results and abnormal ones could predict the prognesis of perinatal fetus.Results The perinatal fetus wite bad prognosis in the fetus with Ⅲ° amniotic fluid contamination with abnormal hemodynamics of S/D,PI,RI are significantly higher than normal ones with Ⅰ°and Ⅱ° amniotic flyid contamination,there are statistically difference between them（P〈0.05）.Conclusion Detecting S/D,PI,RI of fetal hemodynamics of fetal UA,MCA,RA paired with the degree of amniotic fluid contamioation before delivery has especially important clinical signiflcane for predicting the prognosis ofperinatal fetus.