妊娠晚期超声对羊水量评估的临床价值及其影响因素_临床医学论文.docVIP

妊娠晚期超声对羊水量评估的临床价值及其影响因素_临床医学论文 妊娠晚期超声对羊水量评估的临床价值及其影响因素_临床医学论文 【摘要】 目的 探讨妊娠晚期超声对羊水量评估的临床价值及其影响因素。方法 彩色多普勒超声仪测量羊水指数(AFI)，并与产后测得的实际羊水量(AAFV)进行比较，探讨其对AAFV的评估价值。同时记录孕妇的一般情况、产前7天内的超声参数及胎儿附属物等情况，研究影响羊水量(AFV)测量的相关因素，并对影响测量的各参数进行回归分析，预测羊水量。结果 羊水过少(AFI≤50 mm和AFI：51～79 mm)、羊水量正常及羊水过多组的阳性预测值分别为82.6%、40.0%、93.1%、7.1%。AFI、胎儿腹围(AC)对羊水量测量有影响，且具有显著性差异（0.01）。进行回归分析得到回归方程，该方程与羊水过少的阳性预测有很好的相关性。结论 超声对羊水过少(AFI≤50 mm)和正常羊水量具有较高的评估价值，回归方程可以更加精确地估计羊水量。 【关键词】 羊水量；超声；影响因素 Abstract: Objective To study the clinical value of ultrasonography and the influential factors in the assessment of amniotic fluid volume during the last pregnancy term. Methods Color Doppler ultrasound measurement of amniotic fluid index (AFI) was subsequently compared with postpartum actual amniotic fluid volume (AAFV) to investigate the clinical value of ultrasonography in assessing AAFV. Meanwhile, the general health status of the pregnant women, ultrasonic parameters during the last 7 prenatal days and fetal appendage were recorded to make a study of the influential factors. A regression analysis was conducted on the contributing parameters of ultrosonographic measurements to prognosticate AFV. Results The coincidence rates of postpartum oligohydramnios (AFI≤50 mm; AFI: 51～79 mm), normal amniotic fluid volume and polyhydramnios with ultrasonographic results were 82.6%, 40.0%, 93.1% and 7.1%, respectively. AFI and AC may affect ultrasonographic diagnoses, with significant differences. A regression equation y∧=3.5AFI+123 obtained by regression analysis was positively correlated with the prognostication of oligohydramnios. Conclusion Ultrasonography has considerable clinical value in assessing oligohydramnios (AFI≤50 mm) and normal amniotic fluid volume, and regression equation serves to speculate AAFV with higher precision. Key words： amniotic fluid volume; ultrasonography; influential factor 羊水是胎儿正常活动、生长和发育所必需的液体环境。正常羊水量为300～2000 ml，羊水过多的发病率为0.2%～1.6%，羊水过少的发病率达0.5%～5.5%。羊水量异常主要由孕母患病、胎儿畸形，脐带、胎盘、羊膜等病变引起，不管是羊水过多或是羊水过少，都