彩色多普勒超声血流动力学参数在预测胎儿窘迫中的预测价值

Predictive value of hemodynamic parameters of color Doppler ultrasound in predicting fetal distress

目的:分析彩色多普勒超声血流动力学参数在预测胎儿窘迫中的的预测价值。方法:收集2018年1月~2020年12月我院收治的109例胎儿窘迫孕妇的临床资料作为窘迫组,另选择同期我院收治的97例健康孕妇的临床资料作为对照组,比较两组一般资料、脐动脉(UA)血流动力学参数、大脑中动脉(MCA)血流动力学参数及胎儿左心室Tei指数,统计阻力指数(RI)、RI、左心室心肌做工(Tei)指数单独及联合对胎儿窘迫的诊断价值。结果:窘迫组RI_(UA)、血流灌注指数(PI)_(UA)、收缩期/舒张期(S/D)_(UA)及Tei指数高于对照组,RI_(MCA)、PI_(MCA)、S/D_(MCA)低于对照组,二尖瓣口处A峰结束至下一个心动周期E峰开始的时间间隔(a)长于对照组,主动脉射血时间(b)短于对照组。系列联合诊断的特异度、阳性预测值、准确度均高于RI_(ua)、RI_(MCA)、Tei指数单独诊断及平行联合诊断。结论:胎儿窘迫可引起UA血流动力学参数、MCA血流动力学参数及胎儿左心室Tei指数变化,RI_(US)、RI_(MCA)、Tei指数系列联合检测对胎儿窘迫的诊断价值较高。

Objective To analyze the predictive value of hemodynamic parameters of color Doppler ultrasound in predicting fetal distress.Methods Clinical data of 109 pregnant women with fetal distress admitted to our hospital from January 2018 to December 2020 were retrospectively collected as the distress group,and 97 clinical data of healthy pregnant women admitted to our hospital during the same period were selected as the control group.General data,hemodynamic parameters of umbilical artery (UA),middle cerebral artery (MCA) and Tei index of fetal left ventricle were compared between the two groups.The diagnostic value of resistance index (RI_(UA)),RI_(MCA) and fetal left ventricular cardiac work (Tei) index in the diagnosis of fetal distress was analyzed.Results The RI_(UA),perfusion index (PI)_(UA),systolic/diastolic (S/D)_(UA) and Tei of the distress group were higher than those of the control group,RI_(MCA),PI_(MCA),S/D_(MCA) were lower than those of the control group,the interval between the end of peak A at the mitral valve opening and the start of peak E of the next cardiac cycle (a) was longer than that of the control group,Aortic ejection time (b) was shorter than that of control group.The specificity,positive predictive value and accuracy of the combined diagnosis were higher than those of RI_(UA),RI_(MCA) and Tei alone and parallel combined diagnosis.Conclusion Fetal distress could cause changes in hemodynamic parameters of UA,hemodynamic parameters of MCA and Tei index of fetal left ventricle.The combination of RIUA,RIMCA and Tei index series had a higher diagnostic value for fetal distress.