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胎羊间断性脐带闭塞对静脉导管血流动力学的影响

Ductus venosus measurements in the fetal sheep after intermittent umbilical cord occlusion

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【作者】 何韶铮吕国荣李伯义陈秋月苏瑞娟金鹏

【Author】 HE Shao-zheng, LV Guo-rong, LI Bo-yi, CHEN Qiu-yue, SU Rui-juan, JIN Peng(Department of Ultrasound, the Second Affilicated Hospital of Fujian Medical University, Quanzhou 362000, China)

【机构】 福建医科大学附属第二医院福建医科大学附属第二医院 福建泉州362000福建泉州362000

【摘要】 目的探讨胎羊间断性脐带闭塞后静脉导管血流频谱变化的意义。方法12只晚孕山羊(7只实验组,5只对照组)于妊娠116130d行宫内外科手术,用套囊充气闭合器完全夹闭脐带,每次夹闭90s,间隔30min,重复5次。于实验前5min、每次夹闭后3min应用彩色多普勒超声检测静脉导管心室收缩期峰值速度(Vmax)DV、静脉导管峡部的内径(DDV)、搏动指数(PIDV)、DV指数(S-a/S)、血流量(QDV)。结果实验组夹闭后DDV[(1.99±0.16)2.69±0.53mm,P<0.05)]、QDV[(70.25±15.47)171.47±72.16ml/min,P<0.05)]、PIDV[(0.33±0.09)0.7±0.2,P<0.05)]、DV指数[(0.44±0.04)0.62±0.11,P<0.05)]升高;与对照组差异有统计学意义(P<0.01)。实验组DDV、QDV、PIDV、DV指数与血pH呈负相关(r=-0.579,r=-0.681,r=-0.358,r=-0.310,P<0.01)、与PaO2呈负相关(r=-0.564,r=-0.622,r=-0.435,r=-0.483,P<0.01)、与血PaCO2呈正相关(r=0.510,r=0.418,r=0.699,r=0.423,P<0.01)。(Vmax)DV与血气指标无明显相关。结论静脉导管血流频谱可成为预测胎儿宫内缺氧的有效指标。

【Abstract】 Objective To explore the significance of the ductus venosus (DV) Doppler spectrum in fetal sheep with intermittent umbilical cord occlusion (UCO). Methods Twelve late pregnancy sheep (5 for control group and 7 for occlusion group) underwent umbilical cord occlusions (90 s total cord occlusions for 5 times at 30 min intervals) at 116-130 days gestation. The maximum velocity of DV (Vmax)DV, the DV diameter (DDV), the DV pulsation index (PIDV), the DV index (ventricular systole-atrial systole/ventricular systole), the DV blood flow were performed for 5 minutes before the first umbilical cord occlusions and 3 minutes after each occlusion. Results In experimental group animals, the DDV ([1.99±0.16]-[2.69±0.53]mm, P<0.05), the DV blood flow ([70.25±15.47]-[171.47±72.16]ml/min, P<0.05), PIDV ([0.33±0.09]-[0.7±0.2], P<0.05), the DV index ([0.44±0.04]-[0.62±0.11], P<0.05) increased with cord occlusions, and still significantly rose when compared with the control animals. There were negative correlation between DDV, the DV blood flow, PIDV, the DV index and pH (r=-0.579, r=-0.681, r=-0.358, r=-0.310, P<0.01). There were negative correlation between them and PaO2 (r=-0.564, r=-0.622, r=-0.435, r=-0.483, P<0.01). There was significant correlation between them and PaCO2 (r=0.510, r=0.418, r=0.699, r=0.423, P<0.01). There was no significant correlation between (Vmax)DV and blood gas or pH. Conclusion The ductus venosus Doppler spectrum might be an useful quantitative parameter for assessing fetal hypoxemia.

【基金】 福建医科大学科研发展基金项目(FJGXY04023)资助
  • 【文献出处】 中国医学影像技术 ,Chinese Journal of Medical Imaging Technology , 编辑部邮箱 ,2008年05期
  • 【分类号】R714.5
  • 【被引频次】1
  • 【下载频次】39
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