超声评价胎儿窘迫心脏功能改变的研究

Ultrasound for the Assessment of Cardiac Function Change of Fetal distress

目的应用超声心动图观察胎儿窘迫心脏功能改变,尽早发现心功能异常,指导临床对胎儿窘迫心功能异常采取必要的治疗措施,评估疗效以及新生儿评估和治疗。方法应用超声观察20例胎儿窘迫胎儿和30例正常胎儿心脏功能,测量并比较各组间心脏收缩功能、舒张功能及心脏整体功能各项指标。检查中依次获得心尖、心底四腔心、左室流出道、右室流出道、三血管等各切面;获得各瓣口血流频谱,用脉冲或M型彩色DTI测定左室壁运动速度,用脉冲DTI测定二尖瓣、三尖瓣运动速度。结果各项测量指标胎儿窘迫组胎儿与正常组胎儿比较均有统计学差异(P<0.05)。结论超声对胎儿心脏功能各项指标的测量易于操作,重复性好,可以用以综合评价胎儿心脏功能,对于早期发现胎儿窘迫及评估其治疗效果有较大的临床价值。

Objective To observe the cardiac function change of fetal distress by using echocardiography, so as to get the early detection of abnormal heart function and clinical guide on abnormal cardiac function of fetal distress, and to take necessary measures and assess the efficacy of treatment, as well as assessment, treatment after fetal birth. Methods Ultrasound was used to observe the cardiac functions of 20 cases of fetal distress and 30 cases of normal fetus, and the indicators of cardiac systolic function, cardiac diastolic function and overall heart function were measured and compared. The sections of cardiac apex, four-chamber of basis cordis, left ventricular outflow tract, right ventricular outflow tract and three vessels were obtained sequentially. The flow spectrums of heart valves were obtained. The motion speed of left ventricular wall was detected by pulse or M-type color DTI, and the motion speeds of mitral valve and tricuspid valve were detected by pulse DTI. Results All the indicators had statistical difference between fetal distress fetus and normal fetus （P〈0.05）. Conclusions Ultrasound has the advantages of simple operation and good repeatability in the detection of fetal cardiac function indicators, which can be used for comprehensive evaluation of fetal cardiac function, and has high clinical value in early diagnosis of fetal distress and evaluation of therapeutic effect.