无刺激胎心监护对妊娠肝内胆汁淤积症患者发生胎窘的诊断价值

Diagnosis Value of No Stimulation of Fetal Heart Rate Monitoring on Intrahepatic Cholestasis of Pregnancy Patients with the Occurrence of Fetal Distress

目的探讨无刺激胎心监护(No Stimulation of Fetal Heart Rate Monitoring,NST)对妊娠肝内胆汁淤积症(Intrahepatic Cholestasis of Pregnancy,ICP)患者发生胎窘的诊断价值。方法选取我院2014年4月至2016年4月的40例妊娠肝内胆汁淤积症患者进行回顾性分析,作为试验组,选取同期检查的40例正常疤痕子宫产妇作为对照组,两组研究对象均进行NST联合B超进行手术,比较两组产妇的窘迫发生情况和新生儿窒息情况,同时比较NST联合B超、NST联合B超以及联合患者自测胎动对两组产妇的窘迫发生情况。结果试验组胎儿窘迫检出率(50.0%)、新生儿窒息发生率(7.5%)明显低于对照组的窘迫检出率(90.0%)、新生儿窒息发生率(27.5%),具有统计学意义(P<0.05);试验组的NST联合B超及联合患者自测胎动检查出的窘迫率(90.0%)明显高于NST联合B超(50.0%),差异具有统计学意义(P<0.05);对照组NST联合B超及联合患者自测胎动检查、NST联合B超检出的窘迫率无统计学意义(P>0.05);两组产妇的NST联合B超及联合患者自测胎动检查的窘迫率无统计学意义(P>0.05)。结论 NST检查可以准确的检查正常疤痕子宫产妇的胎窘情况,但是NST检查对ICP患者的胎窘具有一定的局限性,需要结合B超检查及联合患者自测胎动可以对ICP患者进行胎窘诊断。

Objective To study the diagnosis value of no stimulation of fetal heart rate monitoring （NST） on intrahepatic cholestasis of pregnancy （ICP） patients with the occurrence of fetal distress. Methods From April 2014 to April 2016, 40 cases of ICP patients were analyzed as the experimental group. Another 40 cases of scar uterus were selected during the same period, and regarded as the control group. Both of the two groups of subjects underwent NST combined with ultrasound and surgery. The maternal distress and the incidence of neonatal asphyxia, as well as the occurrence of maternal distress were compared. Results Both the detection rate of fetal distress, and the incidence of neonatal asphyxia of experimental group were signifcantly lower than that of the control group （P〈0.05）. In the experimental group, the detection rate of fetal distress （90.0%） of NST combined with ultrasound and self-testing was signifcantly higher than that of the NST combined with ultrasound （50.0%）, with statistically signifcant （P〈0.05）. However, in the control group, the distress rate did not statistically signifcant （P〉0.05）. The detection rate between the two groups were also not statistically signifcant （P〉0.05）. Conclusion NST examination can accurately check the fetal distress of normal scarred uterus maternal, but it has limitation in detection of ICP patients with fetal distress. The B-ultrasound and self-testing fetal movement should be combined in fetal diagnosis of ICP patients.