【摘要】 目的:探究多普勒超声参数对中晚孕期胎儿突发宫内窘迫结局的预测价值。方法:回顾性分析2017年10月～2019年12月于我院妇产科病房行多普勒超声监测的120例足月分娩孕妇的临床资料,依据胎心率、羊水粪染及新生儿1min Apgar评分分成正常组及胎儿窘迫组。两组均于中晚孕期采用多普勒超声监测胎儿的脐动脉(UA)、大脑中动脉(MCA)的血流动力学参数[搏动指数(PI)、阻力指数(RI)、收缩期与舒张期流速比(S/D)]及静脉导管(DV)的导管分流率,评估其预测价值。结果:胎儿窘迫组胎儿UA的PI、RI及S/D明显高于正常组(P均<0.05),而MCAPI、RI及S/D明显低于正常组(P<0.05);胎儿窘迫组胎儿DV分流率、a波消失率、A波反向率明显高于正常组(P均<0.05);检查结果显示,联合检测较单独UA、MCA血流动力学参数及DV分流率检测的特异度、敏感度、准确率、阳性预测值、阴性预测值更高,分别为90.32%、97.47%、95.45%、93.33%、96.25%(P<0.05)。结论:多普勒超声参数对中晚孕期胎儿突发宫内窘迫的预测具有一定价值,联合UA、MCA血流动力学参数及DV分流率检测的敏感度最高,可为临床提高围产期质量可靠依据。更多还原

【Abstract】 Objective:to explore the value of Doppler ultrasound parameters in predicting the outcome of fetal sudden intrauterine distress during middle and late pregnancy.Methods:The clinical data of 120 pregnant women with full-term delivery were analyzed retrospectively from October 2017～ December 2019, According to fetal heart rate, amniotic fluid fecal staining and neonatal 1 min Apgar score, normal group and fetal distress group were divided. The hemodynamic parameters [pulsatility index(PI), resistance index(RI), contraction] of umbilical artery(UA) and middle cerebral artery(MCA) were monitored by Doppler ultrasound during mid-late pregnancy The ratio of flow velocity to diastolic velocity(S/D)] and catheter shunt rate of venous catheter(DV), Evaluate its predictive value.Results:The PI、RI and S/D of fetal UA in fetal distress group were significantly higher than those in normal group(P 0.05), MCAPI、RI and S/D were significantly lower than those in normal group(P<0.05); The DV shunt rate, a wave disappearance rate and A wave reverse rate in fetal distress group were significantly higher than those in normal group(P 0.05); The results show, The specificity, sensitivity, accuracy and positive prediction UA、MCA hemodynamics parameters and DV shunt rate were compared with those measured alone values, negative predictive values were higher,90.32%,97.47%,95.45%,93.33%,96.25%, respectively(P<0.05).Conclusion:Doppler ultrasound parameters have certain value in predicting fetal sudden intrauterine distress during middle and late pregnancy. The sensitivity of combined UA、MCA hemodynamic parameters and DV shunt rate is the highest, which can be a reliable basis for clinical improvement of perinatal quality.更多还原