胎儿血氧饱和度监测在产程中的临床意义分析

Clinical significance of fetal oxygen saturation monitoring in stage of labor

目的:探讨胎儿血氧饱和度(FSaO2)监测在产程中的应用,分析其对预测胎儿酸中毒、诊断胎儿窘迫及联用胎心电子监测的临床意义。方法:80例产妇分观察组(胎心内外及胎儿FSaO2监测)、对照组(胎心内外监测),分别在第一产程活跃期及第二产程中进行胎心内、外及胎儿FSaO2监测。分娩后Apgar评分和脐血血气分析,计算敏感度、特异度、阳性预期值、阴性预期值及准确率。结果:观察组及对照组比较,在预测酸中毒、诊断胎儿窘迫的敏感性、特异性、阳性预期值、阴性预期值、准确率等方面均有差异(P<0.01)。FSaO2≤30%持续5min以上预示胎儿有酸中毒的可能,影响围产儿结局。结论:FSaO2可体现胎儿氧合及酸碱平衡状态,准确预测酸中毒和围产儿情况、诊断胎儿宫内窘迫,在产程中联合应用胎心电子内、外监护,可提高监测的准确性和特异性。

Objective： To evaluate the fetal oxygen saturation （FSaO2） monitoring method in the application of labor, and to analyze its diagnosis for predicting fetal acidosis, fetal distress and the clinical significance of the combined cardi- ac electronic surveillance. Method： Eighty women were divided into the observation group （cardiac monitoring inside and outside as well as FSaO2 monitoring） and control group （cardiac monitoring inside and outside）. Apgar score and blood gas analysis of cord blood, sensitivity, specific, positive expected value, negative expected value and accuracy were evaluated after delivery. Results： There were significant differences in the prediction of acidosis, and the sensitivi- ty, specificity, positive expected value, negative expected value, accuracy of the diagnosis of fetal distress between the experimental group and the control group （P 〈 0.01）. Not more than 30% of FSaO2 level lasting for 5 min suggested a fetal acidosis, which affected the perinatal outcome. Conclusion： FSaO2 can reflect the fetal oxygenation and acid-base balance, and predict the acidosis and perinatal situation as well as diagnose fetal distress. Combined of cardiac electronic internal monitoring with external monitoring in labor could improve accuracy and specificity of monitoring.