子宫动脉超声多普勒血流监测在妊娠期高血压疾病晚期中的应用价值分析

Analysis of Uterine Artery Doppler Blood Flow Monitoring for Late Pregnancy Induced Hypertension

目的:探讨子宫动脉超声多普勒血流监测在妊娠期高血压晚期应用价值。方法:选择2012年1月至2014年8月来我院就诊的92例晚期妊娠期高血压疾病患者与87例正常妊娠孕妇作为研究对象,其中晚期妊娠高血压患者为观察组,正常妊娠孕妇作为对照组,应用超声多普勒监测全部研究对象的子宫动脉血流动力学情况,测定血流动力学参数阻力指数(RI)、搏动指数(PI)、收缩-舒张流速比值(S/D),以及记录是否出现舒张早期切迹,随访至所有研究对象妊娠结束,比较两组研究对象子宫动脉血流动力学差异情况,以及其妊娠结局的差异情况,其中包括平均孕周、新生儿体重、体重指数、早产率、剖宫产率以及胎儿窘迫的发生率;同时根据妊娠高血压疾病患者有无出现舒张早期切迹分为切迹组与无切迹组,比较两组患者妊娠结局的差异。结果:1观察组患者的阻力指数(RI),明显高于对照组,二者比较差异显著(P<0.05);观察组患者的搏动指数(PI)明显高于对照组,二者比较差异显著(P<0.05);观察组患者的收缩-舒张流速比值(S/D)明显高于对照组,二者比较差异显著(P<0.05);观察组患者中舒张早期切迹发生率为42.39%,明显高于对照组的9.20%,二者比较差异显著(P<0.05);2观察组患者的平均孕周明显少于对照组,二者比较差异显著(P<0.05);观察组中新生儿体重明显低于对照组,二者比较差异显著(P<0.05);观察组中体重指数明显高于对照组,二者比较差异显著(P<0.05);观察组中的早产率、剖宫产率以及胎儿窘迫的发生率均明显高于对照组,二者比较差异显著(P<0.05);3切迹组患者的平均孕周明显少于无切迹组,二者比较差异显著(P<0.05);切迹组中新生儿体重明显低于无切迹组,二者比较差异显著(P<0.05);切迹组中的羊水异常发生率、早产率、新生儿窒息发生率及胎儿窘迫的发生率均明显高于对照组,二者比较差异显著(P<0.05)。结论:妊娠晚期的子宫动脉舒张早期切迹在妊娠期高血压疾病的中具有应用价值,子宫动脉超声多普勒血流监测能够预测妊娠期高血压疾病围生期的并发症情况,值得临床应用。

Objective： To investigate the value of uterine artery doppler blood flow monitoring for late pregnancy induced hypertension. Method： 92 cases with late pregnancy induced hypertension and 87 cases of normal pregnant women were selected in our hospital from January 2012 to August 2014 as studies,among them patients with hypertension in late pregnancy as the observation group,normal pregnant women as the control group,uterine artery hemodynamics situation of all studies were detected in Doppler,hemodynamic parameters measured resistance index（ RI）,pulsatility index（ PI）,systolic- diastolic velocity ratio（ S /D）,and recording whether had early diastolic notch,all subjects were followed up until the end of pregnancy,uterine artery hemodynamics discrepancy of two groups were compared,and their pregnancy outcome discrepancy,including the average gestational age,birth weight,body mass index,premature birth rate,cesarean section rate and the incidence of fetal distress,they were divided into groups with and without notch notch group according to the presence or absence of early diastolic notch,pregnancy outcomes of two groups were compared. Result： 1 Resistance index（ RI） of the observation group were,significantly higher than that in the control group,difference had statistically significant（ P〈0.05）; Pulsatility index（ PI） of the observation group were,significantly higher than that in the control group,difference had statistically significant（ P〈0.05）; Shrinkage- diastolic flow velocity ratio（ S / D） of the observation group were significantly higher than that in the control group,difference had statistically significant（ P〈0.05）; The incidence of early diastolic notch of the observation group were 42.39%,significantly higher than that of 9.20% in the control group,difference had statistically significant（ P〈0. 05）; 2 The average gestational age of the observation group were significantly lower than that of weeks in the control group,difference had statistically significant（ P0.05）; Birth weight of the observation group were significantly lower than that of in the control group,difference had statistically significant（ P〈0.05）; BMI of the observation group were significantly higher than that in the control group,difference had statistically significant（ P〈0. 05）; The incidence of preterm birth rate,the cesarean section rate and fetal distress of the observation group were significantly higher than the control group,difference had statistically significant（ P〈0.05）; 3The average gestational age of notch group were significantly less than in the non-notch group,difference had statistically significant（ P〈0. 05）; Birth weight of notch group were significantly less than that in the non-notch group,difference had statistically significant（ P〈0.05）; The incidence of abnormal amniotic fluid,premature birth,asphyxia incidence and incidence of fetal distress of notch group were significantly higher than the control group,difference had statistically significant（ P〈0.05）. Conclusion： Uterine artery doppler blood flow monitoring for late pregnancy induced hypertension has application value,uterine artery doppler blood flow monitoring can predict complications of hypertensive disorders in pregnancy perinatal period,worth application in clinical.