孕晚期多普勒超声检测静脉导管预测宫内窘迫胎儿结局的临床价值

Clinical significance of fetal ductus venosus Doppler blood flow in predicting neonatal outcome of fetal distress

目的研究静脉导管多普勒超声检查在预测宫内窘迫胎儿不良出生结局中的临床应用价值。方法选取我院经确诊胎儿宫内窘迫的孕妇62例,依据新生儿出生不同结局分为正常组19例、轻微异常组28例和明显异常组15例。检测比较各组胎儿静脉导管及脐静脉多普勒血流参数变化情况。结果胎儿静脉导管的分流率(QDV/QUV)、心室收缩期峰值流速/心房收缩期峰值流速(DVS/A)及静脉导管的阻力指数(DVRI)均可以作为预测宫内窘迫胎儿明显异常出生结局的有效指标。其中DVS/A受试者工作特征曲线下面积最大,为92%,其次为DVRI,曲线下面积为90%,QDV/QUV曲线下面积为76%。结论 QDV/QUV、DVS/A及DVRI均可作为预测宫内窘迫胎儿明显异常出生结局的有效指标,其中DVS/A及DVRI预测价值较高。

Objective To investigate the application value of ductus venosus Doppler blood flow in predicting neonatal outcome of fetal distress .Methods Doppler flow ultrasound was used to examine the umbilical venous and ductus venosus in 62 pregnant women with fetal distress who were enrolled and divided into three groups according to neonatal outcome , including normality （n=19） ,mild abnormality （n=28） and apparent abnormality groups （n= 15） .Results Resistence index （DVRI） ,ratio of S-peak and A-peak velocity （DVS/A） ,ratio of ductus venosus blood flow volume and umbilical ve-nous blood flow volume （QDV/QUV） could predict serious neonatal outcome of fetal distress .The area under receiver op-erating characteristic curve （AUC） of DVS/A was the biggest （92% ） ,and then DVRI （90% ） followed .The AUC of QDV/QUV was 76% .Conclusion QDV/QUV ,DVS/A and DVRI can all predict serious neonatal outcome of fetal dis-tress ,and DVS/A and DVRI have greater predictive value .