产前无应激试验和产时电子胎心监护对胎儿窘迫的诊断价值

Diagnostic Value of Prenatal Fetal Non-Stress Test and Intrapartum Electronic Fetal Monitoring for Prenatal Distress

目的：探讨无应激试验（NST）、电子胎心监护及两者联合试验,对胎儿窘迫及新生儿预后评估的临床诊断价值。方法：用NST和电子胎心监护对本院120例单胎头位胎心异常的足月孕妇进行监测分析,计算两种方法单独及联合监测胎儿窘迫的灵敏度和特异性。以胎儿窘迫和新生儿窒息的判定标准为依据,作出预后评估。结果：电子胎心监护的灵敏度和特异性均高于NST,比较差异均有统计学意义（P〈0.05）;两者联合试验诊断灵敏度和特异性均比使用上述单一监测手段的计算值偏高;胎儿窘迫组胎儿窘迫率、羊水Ⅱ~Ⅲ度粪染率以及新生儿窒息率均高于胎儿正常组,比较差异均有统计学意义（P〈0.05）。结论：产前NST和产时电子胎心监护均有一定的临床诊断价值,但电子胎心监护在监测的灵敏度和特异性方面更为突出,可及早诊断胎儿窘迫的发生。两者联合试验能加强监测的诊断效果,降低胎儿及新生儿的致残率与致死率,有利于改善胎儿预后。

Objective： To explore the clinical diagnosis value of non-stress test （NST）, electronic fetal monitoring and the combination of the two methods in assessing fetal distress and neonatal prognosis. Method： 120 single birth pregnant women with pole position and abnormal fetal heart fetuses were monitored and analyzed by NST and electronic fetal monitoring.The sensitivity and specificity of the two methods alone and the combination of the two methods were calculated.According to the judge standard of fetal distress and neonatal asphyxia, the prognosis was evaluated.Result： The sensitivity and specificity of electronic＇fetal monitoring were higher than those of the NST, the differences were statistically significant （ P〈0.05 ） .The sensitivity and specificity of the combination methods were higher than those of the single monitoring.The fetal distress rate, the dung dyeing rate of Ⅱ to Ⅲdegree and the incidence rate of neonatal asphyxia in the fetal distress group were higher than those in the normal fetus group, the differences were statistically significant （P〈0.05） . Conclusion： Both prenatal NST and intrapartum electronic fetal monitoring have certain clinical diagnostic value, but the electronic fetal monitoring is more outstanding in the sensitivity and specificity.h can early diagnose fetal distress.The combination method can strengthen the diagnosis effect, reduce the morbidity and mortality of fetuses and newborns, which is good for the improvement of fetal prognosis.