宫内发育迟缓胎儿静脉血流频谱的超声监测临床价值分析

Analysis of the clinical value of ultrasound monitoring of hemodynamic of vein in intrauterine growth retardation fetus

目的研究超声监测宫内发育迟缓胎儿(IUGR)静脉血流频谱的临床价值。方法选取2013年1月至2015年6月接受常规产前超声检查的孕妇120例,其中,45例IUGR作为IUGR组,另75例正常孕妇为对照组。应用彩色多普勒超声监测并比较两组胎儿肾动脉、脐动脉、大脑中动脉(MCA)血流频谱参数,脐静脉(UV)以及静脉导管(DV)血流频谱参数。结果 IUGR组的肾动脉动脉阻力指数(RI)、脐动脉RI、动脉搏动指数(PI)及收缩期峰值流速与舒张末期流速之比(S/D)均高于对照组,大脑中动脉(MCA)的RI、PI以及S/D均低于较对照组,组间比较差异均具有统计学意义(P<0.05);两组肾动脉的PI及S/D比较差异无统计学意义(P>0.05);IUGR组胎儿的静脉导管血流量(QDV)、下腔静脉返流分数及QDV/脐静脉血流量(QUV)较对照组提高,QUV则明显降低,组间比较差异具有统计学意义(P<0.05)。结论超声监测IUGR胎儿静脉血流频谱变化有利于动态评估胎儿宫内血供情况具有重要意义,能够预测和评估胎儿宫内缺氧缺血情况以及IUGR发生情况,值得临床推广应用。

Objective To study the clinical value of ultrasound monitoring of hemodynamic of vein in intrauterine growth retardation fetus.Methods 120 pregnant women in our hospital for routine prenatal ultrasound examination between January 2013 to 2015 June were collected,45 cases as IUGR group,another 75 cases of normal pregnant women as control group.Color Doppler ultrasound were performed to monitor and compare the two umbilical vein （UV） and venous catheters （DV） flow spectrum parameters.Results Renal artery RI,the umbilical artery RI,PI and S/D in IUGR group were higher,RI,PI and S/D of MCA were lower than those of the control group,the difference between groups was statistically significant （P＆lt;0.05）.Renal artery PI and S/D has no significant difference （P＆gt;0.05）.QDV,inferior vena cava reflux scores and QDV/QUV in IUGR group fetus were higher than those of the control group,QUV was significantly lower,the difference between groups was statistically significant （P＆lt;0.05）.Conclusion Ultrasound monitoring of hemodynamic of vein is helpfull for dynamic assessment of fetal blood supply.It can help to predict and assess fetal hypoxia ischemia as well as the occurrence of IUGR,it is worthy of clinical application.