彩色多普勒脐动脉血流检测在脐带绕颈中的应用(1)
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[摘要] 目的：探讨脐动脉血流定点检测估计脐带绕颈对胎儿预后的影响。方法：回顾性分析150例孕妇的胎儿脐带的3个部位，即胎盘附着部(P)、脐带游离部(M)及胎儿脐带附着部(A)的脐动脉血流频谱，检测收缩期速度峰值(S)、舒张末期速度最低值(D)，平均速度(V)，并计算S/D值。结果：46例分娩时有脐带绕颈，104例为正常孕妇。脐带绕颈时，脐动脉3个部位的S/D值失去正常关系(A>M>P)的发生率显著增高(P<0.01)。当脐带绕颈合并脐动脉S/D值失去正常关系(A>M>P)时胎儿窘迫的发生率显著增高(P<0.05)。结论：观察脐带3个部位S/D值的关系可作为衡量脐带绕颈对胎儿危害程度的一种方法，在预测胎儿预后、帮助选择分娩方式上有较大的临床参考价值。
[关键词] 彩色多普勒超声；脐带绕颈；脐动脉血流；胎儿窘迫
[中图分类号]R445.1 [文献标识码] C[文章编号] 1673-7210(2009)03(a)-077-02
The application of umbilical arterial blood flow detected by color doppler ultrasonic in cord entanglement
SU Xue-mei, SHI Xiao-mei*, LIU Pu-yong
(Chengdu No.7 People’s Hospital, Chengdu 610021, China)
[Abstract] Objective: To evaluate the influence of cord entanglement to fetal prognosis by particularly detecting umbilical arterial blood flow. Methods: First, the frequency spectrum of umbilical arterial blood flow were analyticallyreviewed which existed in 150 pregnant women whose 3 fetal umbilical cord potions, that were previous insertion(P), umbilical cord free part(M),fetal umbilical cord insertion(A). Second, the systole peak value rate(S), the late diastole minimum value rate(D) and the average value rate(V) were detected, meanwhile, S/D value were calculated. Results: Among them 46 pregnant women occurred cord entanglement during parturition, another 104 pregnant women didn’t. When there was cord entanglement, the appearance rate of S/D value measured on 3 umbilical artery potions without normal relationship raised remarkably (P<0.01). When cord entanglement combined S/D value of fetal distress raised remarkably(P<0.05). Conclusion: Observing relation of 3 umbilical cord potion S/D value, can be used as a method to survey the harm degree of cord entanglement to fetal, to guard fetal subject to highly dangerous factors effectively, and also has quite good clinic reference value in forecasting fetal prognosis and helping how to choose delivering way.
[Key words] Color doppler ultrasonic; Cord entanglement; Umbilical arterial blood flow; Fetal distress ......
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