彩色多普勒超声对晚孕期羊水过少胎儿肾动脉及大脑中动脉血流的观察

Observation of late pregnancy with oligohydramnios fetal renal artery′s and middle cerebral artery′s blood flow with color Doppler ultrasound

目的：应用彩色多普勒血流显像技术（CDFI）观察晚孕期羊水过少胎儿肾动脉及胎儿大脑中动脉血流的变化，同时建立常州地区晚孕期胎儿肾动脉及大脑中动脉的超声多普勒正常值范围。方法应用彩色多普勒超声检测200例健康晚孕期（35~42周）胎儿的肾动脉及大脑中动脉的搏动指数（PI）、阻力指数（RI）、收缩期最大血流速度与舒张末期速度之比值（S/D），同时研究同期200例同孕龄羊水过少胎儿的肾动脉及大脑中动脉的血流变化。结果羊水过少的晚孕期胎儿肾动脉的PI值、RI值、S/D值较相对照组增高明显，而羊水过少的晚孕期胎儿大脑中动脉的PI值、RI值、S/D值较对照组降低显著。若以大脑中动脉S/D＜4，PI＜1.6，RI＜0.6；肾动脉S/D＞5，PI＞1.9，RI＞0.8，同时结合PI 大脑中动脉/PI 肾动脉比值预测胎儿宫内缺氧有独特的临床实用价值。结论晚孕期应用彩色多普勒超声监测羊水过少胎儿的肾动脉及大脑中动脉血流，为临床早期诊治高危妊娠提供理论依据，对预测胎儿宫内缺氧有一定的临床意义。

Objective Using color Doppler flow imaging （CDFI） to observe the changes of the late pregnancy fetal renal artery′s （RA） and middle cerebral artery′s （MCA） blood flow with oligohydramnios, at the same time establishing the ultrasound Doppler′s normal range of the late pregnancy fetal renal artery and middle cerebral artery in Changzhou region. Methods Using color Doppler ultrasound to gauge 200 cases of normal late pregnancy（35-42 weeks） of fetal renal artery and middle cerebral artery pulsation index （PI）, resistance index （RI）, systolic blood flow velocity and the largest end-diastolic velocity ratio（S/D）, at the same time study 200 cases of fetal renal artery′s and middle cerebral artery′s blood flow changes with oligohydramnios in the same period with gestational age. Results The late pregnancy fetal renal artery′s PI, RI, S/D values with oligohydramnios are significantly higher than they are in control group, however the late pregnancy fetal middle cerebral artery′s PI, RI, S/D values with oligohydramnios are significantly decreased than they are in control group. If using middle cerebral artery′s S/D〈4, PI〈1.6 and RI〈0.6;renal artery′s S/D〉5, PI〉1.9, RI〉0.8, at the same time, with the ratio of PIMCA/PIRA as a standard to predict the fetus intrauterine hypo-xia has specific clinical value of application. Conclusion In late pregnancy using color Doppler ultrasound to monitor the fetal renal artery and middle cerebral artery blood flow with oligohydramnios , as to provide theoretical basis for clinical diagnosis and treatment of early high-risk pregnancy, and there are certain clinical significance predicting the fetus intrauterine hypoxia.