彩色多普勒超声监测血流动力学参数的变化预测胎儿宫内窘迫的临床价值

The Clinical Value of Color Doppler Ultrasound Monitoring Changes in Hemodynamic Parameters for Predicting Fetal Intrauterine Distress

目的观察彩色多普勒超声监测血流动力学参数的变化预测胎儿宫内窘迫的价值。方法回顾性分析2021年1月—2022年1月在石狮市妇幼保健院临床诊断为胎儿宫内窘迫的50例新生儿为研究组,并将同期50名健康新生儿设为对照组。分析两组胎儿脐动脉及大脑中动脉血流动力学参数。分析彩超胎心异常诊断准确性。结果研究组脐动脉血流动力学参数中收缩期末血流速度(velocity systolic,Vs)、胎儿脐动脉收缩压与舒张压之比(systolic/diastolic ratio,S/D)、脐动脉阻力指数(umbilical artery resistance index,RI)、搏动指数(pulsatility index,PI)指标更高,而舒张期末血流速度(velocity diastolic,Vd)指标更低(P<0.05)。研究组大脑中动脉血流动力学参数均低于对照组(P<0.05)。超声诊断中胎心异常检出率及胎儿窘迫检出率与临床诊断比较,差异无统计学意义(P>0.05)。结论在产前检查中,以彩色多普勒超声监测血流动力学参数对胎儿宫内窘迫发生率及其严重程度进行预测,从而有利于临床针对此类妊娠女性进行早期干预,对于医学质量及优生优育的提升具有重大意义。

Objective To observe the clinical value of color Doppler ultrasound monitoring hemodynamic parameters in predicting fetal distress.Methods A total of 50 neonates clinically diagnosed with intrauterine distress in Shishi Maternal and Child Health Care Hospital from January 2021 to January 2022 were retrospectively analyzed as the study group,and 50 healthy neonates in the same period were set as the control group.The hemodynamic parameters of fetal umbilical artery and middle cerebral artery were analyzed.The accuracy of color Doppler ultrasound in the diagnosis of fetal heart abnormalities were analyzed.Results The indexes of velocity systolic(Vs),systolic/diastolic ratio(S/D),umbilical artery resistance index(RI)and pulsatility index(PI)of fetal umbilical artery hemodynamics in the study group were higher than those in the control group,while the indexes of velocity diastolic(Vd)were lower than those in the control group(P<0.05).The indexes of Vs,Vd,S/D,RI and PI of fetal middle cerebral artery hemodynamics in the study group were lower than those in the control group (P < 0.05). There was no significant difference between the detection rate of fetal heart abnormalities and fetal distress in ultrasound diagnosis and clinical diagnosis (P > 0.05). Conclusion The implementation of color Doppler ultrasound to monitor hemodynamic parameters during prenatal examination can predict the incidence and severity of fetal distress in utero, which is conducive to the early intervention of clinical acupuncture for such pregnant women, and has great significance for the improvement of medical quality and eugenics.