子痫前期胎儿血流检测与围生儿预后分析

The blood flow detection and perinatal prognosis analysis of preeclampsia fetal

目的探讨子痫前期胎儿血流检测与围生儿预后分析。方法我院于2012年7月~2014年7月对120例妊娠20周后的孕妇进行回顾性研究,分为研究组和对照组各60例,研究组为子痫前期胎儿;对照组为正常妊娠胎儿。两组均采用彩色多普勒超声仪于24周~27周＋6、28周~31周＋6、32周~分娩前进行检测：静脉导管及脐静脉、脐动脉及大脑中动脉血流的各项参数变化,并与围产儿预后情况进行比较分析。结果无论轻度还是重度子痫胎儿阻力指数（RI）、静脉导管的前负荷指数（PLL）、峰值流速指数（PVIV）、搏动指数（PIV）、静脉导管分流率（Qdv-静脉导管血流量/Quv-脐静脉血流量）的数值均明显高于对照组,差异具有统计学意义（P〈0.01）。正常结局组的PLL、PVIV、PIV、S/A、Qdv/Quv的数值均低于不良结局组,差异具有统计学意义（P〈0.05）。研究组的体重和新生儿Apgar评分均低于对照组,差异具有统计学意义（P〈0.05）;两组的脐静脉p H值和脐动脉血氧饱和度之间无明显差异（P〉0.05）。结论子痫前期胎儿的静脉导管及脐静脉血流异常或波形改变与围产儿不良结局存在一定关系。

Objective To study the prognosis in preeclampsia fetal blood flow detection and perinatals analysis. Methods From July 2012 to July 2014, 120 cases of pregnant women at 20 weeks of gestation conducted a retrospective studied in our hospital, were divided into the research group and the control group（n=60）, the research group was preeclamp- sia fetus; The control group was normal pregnancy fetus. Two groups all used color doppler ultrasound instrument from 24 weeks-27 weeks＋6, to 28 weeks -31 weeks＋6,32 weeks to be tested before delivery： venous catheter and umbili- cal vein, umbilical artery and middle cerebral artery blood flow parameters change, and perinatal prognosis were ana- lyzed. Results Both mild and severe pre-eclampsia fetal resistance index （RI）, venous catheter before load index（PLL）, peak flow velocity（PVIV）, pulse index（PIV）, intravenous catheter FenLiuLv（Qdv-venous catheter blood flow/Quv-umbil- ical venous blood flow） values were significantly higher than that of control group, the difference was statistical signifi- cant（P〈O.01）. The normal end of PLL, PVIV, PIV, S/A and Qdv aderse outcome/Quv values were lower than group, the difference was statistical significant （P〈0.05）. The team＇s weight and neonatal Apgar score were lower than the control group,the difference was not statistical significant（P〉0.05）; Two groups of umbilical vein between pH and umbilical arte- rial blood oxygen saturation had no obvious difference （P〉0.05）. Conclusion Preeclampsia fetal abnormal venous catheter and umbilical vein blood flow or waveform changes have a certain relationship with poor perinatal outcomes.