胎儿脐血流和大脑中动脉参数在羊膜腔灌注中的对比分析

Comparison between fetal umbilical cord blood flow parameters and middle cerebral artery peak systolic velocity in amniotic infusion therapy for oligohydramnios

目的对比羊膜腔灌注前后,羊水过少胎儿脐血流参数及大脑中动脉峰值流速变化,以了解羊膜腔灌注治疗对胎儿脐带及大脑中动脉血流的影响。方法选择2014-01~2016-12羊水过少妊娠22~33周的孕妇18例,进行羊膜腔灌注,比较羊膜腔灌注前后的羊水指数(AI)及脐血流参数、胎儿大脑中动脉峰值流速(MCA-PSV)的变化。结果羊膜腔灌注术后AI明显增加,S/D比值下降,差异有统计学意义(P<0.01);羊膜腔灌注术后阻力指数(RI)下降,差异有统计学意义(P<0.05);MCA-PSV略有上升,但差异无统计学意义。结论羊膜腔灌注可以短时间明显增加羊水量,改善胎儿脐血流,对胎儿大脑中动脉峰值流速无影响。

Objective To compare the changes of umbilical cord blood flow parameters and the middle cerebral artery peak systolic velocity before and after the amniotic infusion therapy,and to explore the effect of amniotic infusion therapy on fetal umbilical cord blood flow and middle cerebral artery peak systolic velocity（ MCA-PSV） in oligohydramnios. Methods 18 pregnant women who had been diagnosed with oligohydramnios by sonography between22 and 33 gestational weeks received amniotic infusion in our department from January 2014 to December 2016. The amniotic fluid index（ AI）,umbilical blood flow parameters such as S/D,RI and middle cerebral artery peak systolic velocity（ MCA-PSV） were recorded and compared before and after amniotic infusion. Results The amniotic fluid index was improved significantly（ P〈0. 01）,S/D and RI were both decreased significantly（ P〈0. 01,P〈0. 05） after amniotic infusion,but MCA-PSV was not markedly changed. Conclusion Amniotic infusion therapy can improve amniotic fluid index and umbilical artery flow parameters in a short period,but has no effect on the peak systolic velocity of the middle cerebral artery.