妊娠期脐血流监测与胎儿窘迫的关系研究

Correlation research of umbilical blood flow detection and fetal distress at gestation period

目的探讨妊娠期脐血流监测与胎儿窘迫的相关性。方法选取2010年1月~2015年7月本院收治的710例足月妊娠孕妇作为研究对象,所有孕妇均在产前进行脐动脉血流检测,按照有无胎儿窘迫分为正常组（662例）与窘迫组（48例）,比较两组的阻力指数（RI）、搏动指数（PI）以及脐动脉收缩期峰值和舒张期流速之比（S/D）,并分析S/D值与新生儿预后的相关性。结果窘迫组的脐动脉RI、PI、S/D分别为0.67±0.02、1.75±0.19与2.90±0.45,显著高于正常组的0.45±0.03、1.35±0.17与2.12±0.34,差异有统计学意义（P〈0.05）。按照S/D值将窘迫组分为两组,其中S/D〈3组14例,S/D≥3组34例。S/D〈3组中,新生儿Apgar评分〈7分者1例（7.1%）,S/D≥3组12例（35.3%）,差异有统计学意义（P〈0.05）;S/D〈3组发生羊水污染2例（14.3%）,S/D≥3组18例（52.9%）,差异有统计学意义（P〈0.05）;S/D〈3组中,脐血血气分析〈7.30者1例（7.1%）,S/D≥3组14例（41.2%）,差异有统计学意义（P〈0.05）;提示S/D值与Apgar评分、羊水污染及脐血血气分析结果具有显著相关性。结论脐血流指标可准确地反映胎儿在宫内的供血供氧情况,可作为早期诊断胎儿窘迫及预后判断的可靠指标。

Objective To explore the correlation of umbilical blood flow detection and fetal distress at gestation period.Methods 710 full-term pregnant women treated in our hospital from January 2010 to July 2015 were selected as research object.Before delivery,all the women were received the umbilical blood flow detection.The women were divided into distress group（662 cases） and distress group（48 cases） according to the incidence of fetal distress.RI,PI and S/D in two groups was compared,and the correlation of S/D and neonatal prognosis was analyzed. Results RI,PI and S/D in fetal distress group was respectively 0.67 ±0.02,1.75 ±0.19 and 2.90 ±0.45,which was significantly higher than 0.45 ±0.03,1.35±0.17 and 2.12±0.34 of normal group,the difference was significant（P〈0.05）.There were 14 cases with S/D〈3and 34 cases with S/D≥3.For S/D〈3 group,there was 1 case（7.1%） with Apgar〈7 scores,and for S/D≥3 group,12 cases（35.3%） with Apgar〈7 scores, the difference was significant（P〈0.05）.In S/D〈3 group,2 cases（14.3%） with amniotic fluid,in S/D≥3 group,18 cases（52.9%） with amniotic fluid,the difference was significant（P〈0.05）.In S/D〈3 group,1 case（7.1%） with cord blood gas analysis 〈7.30,and in S/D≥3 group,14 cases（41.2%） with cord blood gas analysis 〈7.30,the difference was significant（P〈0.05）. S/D and Apgar score,amniotic fluid and cord blood gas analysis results had signicant correlation. Conclusion The umbilical blood flow index can precisely reflect the fetal blood supply and oxygen supply in utero.It can be regarded as a reliable index for the early diagnosis of fetal distress and prediction of prognosis.