超声多普勒血流参数对胎儿宫内窘迫的诊断价值研究

The Diagnostic Value of Ultrasound Doppler Flow Parameters in Fetal Distress

目的 探究超声多普勒血流参数对胎儿宫内窘迫的诊断价值。方法 选择2021年3月至2022年12月阜阳市人民医院收治的95例出现胎儿宫内窘迫孕妇作为研究组,选择60例同期在医院体检的健康孕妇作为对照组,测定并比较胎儿脐动脉及大脑中动脉血流参数,分析血流参数对胎儿宫内窘迫诊断价值;研究组依据宫内窘迫程度分为轻度组(53例)、中度组(28例)、重度组(14例),比较不同组别胎儿血流参数与分娩结局差异,分析胎儿血流参数与宫内窘迫程度相关性。结果 研究组胎儿脐动脉收缩期峰值流速与舒张末期血流速度的比值(S/D)、血流阻力指数(RI)、搏动指数(PI)均高于对照组,大脑中动脉S/D、RI、PI均低于对照组,差异有统计学意义(P<0.05);受试者工作特征(ROC)曲线显示脐动脉S/D、RI、PI对胎儿宫内窘迫诊断曲线下面积(AUC)分别为0.717、0.815、0.752,大脑中动脉S/D、RI、PI对胎儿宫内窘迫诊断AUC分别为0.721、0.657、0.764;随着宫内窘迫程度增加,胎儿脐动脉S/D、RI、PI逐渐增加,大脑中动脉S/D、RI、PI逐渐下降,产妇剖宫产率与早产率上升(P<0.05);Spearman相关性分析显示脐动脉S/D、RI、PI与宫内窘迫程度呈正相关(P<0.05),大脑中动脉S/D、RI、PI与宫内窘迫程度呈负相关(P<0.05)。结论 超声多普勒测定脐动脉与大脑中动脉血流参数不仅可用于指导胎儿宫内窘迫诊断,还可用于胎儿宫内窘迫病情评估,可以为胎儿宫内窘迫病情诊断与评估提供参考。

Objective To explore the diagnostic value of ultrasound Doppler flow parameters in fetal distress.Methods A total of 95pregnant women with fetal distress admitted to Fuyang City People's Hospital from March 2021 to December 2022 were selected as the study group,and 60 healthy pregnant women who underwent physical examination in the hospital during the same period were selected as the control group.The blood flow parameters of fetal umbilical artery and middle cerebral artery were measured and compared to analyze the diagnostic value of blood flow parameters in fetal distress.According to the degree of intrauterine distress,the study group was grouped into 53 cases in the mild group,28 cases in the moderate group and 14 cases in the severe group,respectively.The differences in fetal blood flow parameters of different degrees of intrauterine distress were compared,and the correlation between fetal blood flow parameters and delivery outcomes was analyzed.Results The ratio of fetal umbilical artery systolic peak velocity to end-diastolic flow velocity(S/D),blood flow resistance index(RI)and pulsation index(PI) in the study group were higher than those in the control group,while the S/D,RI and PI of middle cerebral artery in the study group were lower than those in the control group,with statistically significant differences(P < 0.05);the receiver characteristic curve(ROC) showed that the area under the curve(AUC) of umbilical artery S/D,RI and PI for diagnosing fetal distress was 0.717,0.815 and 0.752,respectively.The AUC of middle cerebral artery S/D,RI and PI for diagnosing fetal distress was 0.721,0.657 and 0.764,respectively;with the increase of the degree of intrauterine distress,the umbilical artery S/D,RI,PI increased gradually,while the middle cerebral artery S/D,RI,PI decreased gradually(P < 0.05);Spearman correlation analysis showed that the umbilical artery S/D,RI and PI were positively correlated with the degree of intrauterine distress(P < 0.05),while the middle cerebral artery S/D,RI and PI were negatively correlated with the degree of intra?uterine distress(P < 0.05).Conclusions The measurement of blood flow parameters of umbilical artery and middle cerebral artery by ultra?sound Doppler can not only guide the diagnosis of fetal distress,but also be used to evaluate the condition of fetal distress,which can provide reference for the diagnosis and evaluation of fetal distress.