胎心率基线变异减弱或消失与产妇分娩方式及新生儿结局临床研究.docVIP

胎心率基线变异减弱或消失与产妇分娩方式及新生儿结局临床研究 　　[摘要] 目的 探讨胎心率基线变异减弱或消失与分娩方式及新生儿结局的关系。 方法 选择2011年10月～2013年5月在浙江大学医学院附属第二医院建德分院单胎孕妇电子胎心监护中胎心率基线变异减弱或消失者40例（观察组），随机选取同期行电子胎心监护提示胎心率基线变异正常40例（对照组），比较两组产妇脐带异常及胎盘异常、NST类型、剖宫产、死胎、重度窒息、足月小样儿的情况，及两组不同NST类型与新生儿Apgar评分的关系。 结果 观察组产妇出现帆状胎盘、胎盘早剥、球拍状胎盘、脐带绕颈伴细长、脐带绕颈伴螺旋型、脐带先露、合并羊水污染Ⅱ度以上均高于对照组，差异有统计学意义（P 0.05）。观察组产妇NST可疑型、NST无反应型均高于对照组，差异有统计学意义（P 0.05）。观察组产妇剖宫产[34例（85.0%）]高于对照组[9例（22.5%）]，而新生儿出现重度窒息[3例（7.5%）]、死亡[2例（5.0%）]、足月小样儿[3例（7.5%）]明显高于对照组[0例（0.0%），0例（0.0%），0例（0.0%）]，差异有统计学意义（P 0.05）。观察组NST可疑型新生儿Apgar评分≥7分者低于对照组（55.56%比100.00%），差异有统计学意义（P 0.05），而新生儿Apgar评分 7分者高于对照组（44.44%比0.00%），差异有统计学意义（P 0.05）。 结论 胎心监护胎心率基线变异减弱或消失提示发生胎儿宫内发生窘迫及缺氧，同时结合NST进行积极的处理，如及时终止妊娠，才能进一步降低新生儿病死率、病残率。 　　[关键词] 胎心率基线变异减弱或消失；分娩方式；新生儿结局 　　[中图分类号] R714.51[文献标识码] A[文章编号] 1673-7210（2014）06（c）-0074-04 　　 　　Clinical research of Baseline fetal heart rate variability decreased or disappeared for delivery and pregnancy outcomes 　　ZHU Caihong 　　Department of Obstetrics and Gynecology, Jiande Branch Hospital of the Second Hospital Affiliated to Zhejiang University School of Medicinethe First Peoples Hospital of Jiande City, Zhejiang Province, Jiande 311600, China 　　[Abstract] Objective To investigate the relationship between baseline fetal heart rate variability decreased or disappeared and the delivery mode and neonatal outcomes. Methods From October 2011 to May 2013 in Jiande Branch Hospital of the Second Hospital Affiliated to Zhejiang University School of Medicine, 40 pregnancies with single pregnancies and electronic fetal monitoring showed that the baseline fetal heart rate variability decreased or disappeared were selected as observation group, and at the same time 40 patients of electronic fetal monitoring showed fetal tips normal baseline heart rate variability were randomly selected as control group. The maternal umbilical cord and placenta abnormalities, NST type, cesarean section, stillbirth, severe asphyxia, the ratio of full-term age small gestational,and the re