动态血压联合胎儿脐血流监测在妊娠高血压疾病中的应用价值

Application Value of Ambulatory Blood Pressure Combined with Fetal Umbilical Cord Blood Flow Monitoring in Hypertensive Diseases of Pregnancy

目的:探讨动态血压联合胎儿脐血流监测在妊娠高血压(HDP)患者中的应用价值。方法:回顾性分析2022年1月—2023年1月广东医科大学顺德妇女儿童医院产科收治的HDP孕妇150例的临床资料,依据HDP严重程度分为HDP组、子痫前期组、重度子痫前期组,各50例。另选择同期进行产前检查的正常孕妇50例为对照组。比较各组动态血压、脐血流监测情况及妊娠结局。结果:HDP组、子痫前期组及重度子痫前期组昼间及夜间收缩压、舒张压水平均高于对照组,且重度子痫前期组更高,差异有统计学意义(P<0.05);HDP组、子痫前期组及重度子痫前期组舒张末期血流速度、阻力指数、搏动指数及收缩期峰值血流速度/舒张末期血流速度比值水平均高于对照组,且重度子痫前期组更高,差异有统计学意义(P<0.05);重度子痫前期组早产、剖宫产、胎儿窘迫及新生儿窒息发生率均高于子痫前期组、HDP组及对照组,差异有统计学意义(P<0.05)。结论:对HDP患者行动态血压联合胎儿脐血流监测能够实时监测胎儿生长发育情况,对改善妊娠结局具有重要作用。

Objective:To investigate the application value of ambulatory blood pressure combined with fetal umbilical cord blood flow monitoring in patients with gestational hypertension(HDP).Methods:Clinical data of one hundred and fifty pregnant women with HDP admitted to the obstetrics department of Shunde Women and Children's Hospital of Guangdong Medical University from January 2022 to January 2023 were retrospectively analyzed.According to the severity of HDP,they were divided into HDP group,preeclampsia group and severe preeclampsia group,with fifty cases each.Another fifty normal pregnant women who underwent prenatal examination at the same period were selected as the control group.Ambulate blood pressure,umbilical cord blood flow monitoring and pregnancy outcome were compared among all groups.Results:Daytime and nighttime systolic and diastolic blood pressure levels in HDP group,preeclampsia group and severe preeclampsia group were higher than those in control group,and the levels in severe preeclampsia group were higher,the difference was statistically significant(P<0.05);the end-diastolic blood flow velocity,resistance index,pulse index and the ratio of peak systolic blood flow velocity to end-diastolic blood flow velocity in HDP group,preeclampsia group and severe preeclampsia group were higher than those in control group,the severe preeclampsia group had a higher incidence,and the difference was statistically significant(P<0.05);the incidence of preterm birth,cesarean section,fetal distress and neonatal asphyxia in severe preeclampsia group was higher than that in preeclampsia group,HDP group and control group,and the difference was statistically significant(P<0.05).Conclusion:Ambulate blood pressure combined with fetal umbilical cord blood flow monitoring in HDP patients can monitor fetal growth and development in real time,which plays an important role in improving pregnancy outcome.