彩超监测脐动脉与子宫螺旋动脉对高危妊娠研究.docVIP

彩超监测脐动脉与子宫螺旋动脉对高危妊娠研究 　　[摘要]目的 通过彩色多普勒超声联合监测晚孕期高危妊娠患者胎儿脐动脉（UA）及子宫螺旋动脉（SA）血流参数指标，探讨晚孕期高危妊娠胎儿脐动脉、子宫螺旋动脉血流动力学的变化，以及两者联合监测对预测围产儿结局的临床应用价值。方法 应用彩色多普勒超声对120例单胎晚期妊娠妇女胎儿的脐动脉及母体子宫螺旋动脉的血流进行检测，分别测量以下血流参数：收缩期峰值速度与舒张期末速度之比值（S/D），阻力指数（RI）及搏动指数（pulsatility index，PI），80例高危妊娠与40例正常妊娠组作对照分析。结果 （1）高危妊娠组胎儿脐动脉及子宫螺旋动脉血流S/D、RI、PI值高于正常妊娠组，差异有统计学意义（P0.05）；（2）高危妊娠组围产儿结局异常的百分比明显高于正常妊娠组，差异有统计学意义（P0.05）；（3）当胎儿脐动脉和子宫螺旋动脉血流参数指标都异常时，围产儿结局不良发生率为80.00%，明显高于胎儿脐动脉或子宫螺旋动脉单独异常组，且各组间比较差异均有统计学意义（P0.05）。结论 妊娠晚期彩色多普勒超声检测胎儿脐动脉、子宫螺旋动脉的血流状态，对预测妊娠结局的发生有临床价值；两者联合检测比单纯胎儿脐动脉或子宫螺旋动脉监测对预测高危妊娠胎儿不良结局更有价值；子宫螺旋动脉可以作为脐动脉预测不良妊娠结局的补充。 　　[关键词] 高危妊娠；脐动脉；子宫螺旋动脉 　　[中图分类号] R445.1 [文献标识码] B [文章编号] 2095-0616（2014）07-21-05 　　Study of color doppler ultrasound used in monitoring umbilical artery and uterine spiral artery in high risk pregnancy 　　WANG Yan1 WANG Yinghua2 　　1.Shanxi Medical University， Taiyuan 030001，China；2.Department of Obstetrics and Gynecology， First Affiliated Hospital of Shanxi Medical University， Taiyuan 030001，China 　　[Abstract] Objective To monitor the blood stream parameter indices of the fetal umbilical artery（UA） and uterine spiral artery（SA） of the patients with late gestation high risk pregnancy through the color doppler ultrasound and explore the hemodynamic changes of fetal UA and uterine SA of the patients with late gestation high risk pregnancy and the clinical application value of joint monitoring of the two arteries in predicting the perinatal infants outcomes. Methods The color doppler ultrasound was used to detect the blood stream of fetal UA and uterine SA of 120 patients with single birth late pregnancy and the following blood stream parameters were measured： peak systolic velocity/end diastolic velocity（S/D）， resistance index（RI） and pulsatility index（PI）. Eighty patients with high risk pregnancy and 40 patients with normal pregnancy served as the control group. Results （1）The high risk pregnancy group was higher than the normal pregnancy group in the blood stream S/D， RI and PI values