【摘要】 目的： 评价血液动力学指标预测胎儿缺氧及酸中毒的价值。方法： 用彩色多普勒超声检测 ５４ 例正常晚 期妊娠 （正常组） 和 ３６ 例高危妊娠 （高危组） 妇女子宫动脉 （ＵｔＡ） 和胎儿脐动脉 （Ｕｍ Ａ）、大脑中动脉（Ｍ ＣＡ）、肾动脉 （ＲＡ） 的血流速度波型 （ＦＶＷ ｓ）， 并且测定高危组脐动脉血气。结果： 高危组ＵｔＡ、Ｕｍ Ａ、ＲＡ 的阻力指数 （ＲＩ） 搏动指数 （ＰＩ） 及收缩期最大血流速度与舒张末期血流速度的比值 （Ｓ／Ｄ） 均高于正常组， 而Ｍ ＣＡ的ＰＩ及Ｓ／Ｄ 值均明显低于正常组 （Ｐ＜ ００５）。与Ｕｍ Ａ 氧分压 （ＰＯ２） ＞ ２５ｋＰａ 的高危妊娠病例比较， Ｕｍ Ａ ＰＯ２＜２５ ｋＰａ 者ＵｔＡ 的Ｓ／Ｄ 值， Ｕｍ Ａ 的ＰＩ， Ｓ／Ｄ 值以及ＲＡ 的ＲＩ、ＰＩ、Ｓ／Ｄ 值均明显增高， Ｍ ＣＡ 的ＰＩ明显降低 （Ｐ＜００５）。Ｕｍ Ａ 及ＲＡ 的ＰＩ与Ｕｍ Ａ ＰＯ２ 的ｐＨ 值呈负相关， 与二氧化碳分压 （ＰＣＯ２） 呈正相关， Ｍ ＣＡ 的ＰＩ与Ｕｍ Ａ的 ｐＨ、ＰＯ２ 呈正相关， 与ＰＣＯ２ 呈负相关。结论： 高危妊娠胎儿缺氧时， Ｍ ＣＡ 血流阻力降低， 而周围血管， 特别是肾血管血流阻力明显升高。胎儿血液动力学变化与缺氧及酸碱平衡失更多还原

【Abstract】 Objective:To evaluate the effect of uterine placental fetal blood flow velocity waveforms(FVWs)on prdicting fetal hypoxia and acidosis in high risk pregnancy.Methods:54 women of normal term pregnancy(normal group)and 36 women of high risk term pregnancy(high risk group)were examined with colour Doppler ultrasound for their FVWs including maternal uterine artery(UtA),fetal umbilical artery(UmA),middle cerebral artery(MCA),and renal artery(RA).Umbilical artery blood gases were analysed at delivery in high risk group.Results:The resistance index(RI),pulsatile index(PI)and ratio of peak systolic to least diastolic flow velocity(S/D)of UtA,UmA and RA were higher,the PI S/D of MCA were lower significantly in the high risk group than that of normal group( P <0 05).In the high risk pregnancy,when UmA PO 2 was less than 2 5 kPa,the S/D of UtA,PI,S/D of UmA and RI,PI,S/D were increased,and the PI of MCA was decreased( P <0 05).There were positive correlations between PI of UmA,RA and PO 2,pH of UmA,and negative correlaton between the former and PCO 2 of UmA.But there were negative correlations between PI of MCA and PO 2,pH of UmA and posilive correlations berween the former and UmA PCO 2.Conclusion:In the high risk pregnaney,fetal cerebral blood flow increased,whereas blood flow of fetal peripheral vessels especially renal vessel decreased.There is a good correlation between fetal hypoxia and fetal blood FVWs.The indications of the fetal blood FVWs can identify fetal hypoxia and acidosis.更多还原