中晚孕期正常胎儿静脉导管血流动力学探讨.docVIP

中图分类号:R445.1 文献标识码:A 文章编号：1672-3783(2010)-05-0001-04 【摘要】目的建立中晚孕期正常胎儿静脉导管 多普勒血流参数参考范围。方法应用彩色多普勒超声 检查132例16?41孕周正常单胎胎儿。在静脉导管入 口处记录静脉导管血流波形，测定血流参数包括:心室 收缩期峰值流速⑸、心室舒张期峰值流速(D)、心房收 缩期最大流速(A)、平均流速(Vmean)、S/A值、SID值、 (S-A)/S值、(S-A)/D值和(S-A)/Vmean值。结果正常胎 儿静脉导管的血流参数S、D、A、Vmean随着孕龄的 增加而增加(均P0.05)。结论正常胎儿静脉导管血流 波形呈特殊的三相波形,血流速度随着孕龄增加而增 加，而阻力指数随着孕龄增加而减低.S/D值在妊娠中 持续不变。 【关键词】超声检查，产前;静脉导管;血液动力学 现象 Hemodynamics of Ductus Venosus in Normal Fetus During Second and Third Trimester NIU Min-chang (Department of UltrasonograghyHekou Hospital of Chinese Medicine,Hekou 257234,China) 【Abstract】 Objective To establish reference ranges with gestation for Doppler parameters of fetal ductus venosus(DV).?Methods Color Doppler ultrasound was used to examine 132 normal singleton pregnancies at 16-41 weeks gestation.Flow velocity waveforms were recorded from the ductus venosus.Peak velocity during ventricular systole(S-peak).peak velocity during ventricular diastole (D-peak),lowest velocity during atrial contraction(Awave) and mean velocity(Vmean) were measured at DV inlet and S/A ratio.S/D ratio.(S-A)/S ratio,(S-A)/D ratio and (S-A)/Vmean ratio were calculated.Results The blood velocity of DV:S-peak,D-peak,A-wave and Vmean increased with advancing gestational age( P0.05).Conclusions The normal Doppler flow waveform of the DV in fetuses have characteristic triphasic pattern.The blood flow velocity of DV increased with advancing gestational age.while indices of pulsatility for flow in the ductus venosus decreased with advancing gestational age.S/D ratio remains constant throughout gestation. 【Keywords】 Ultrasonography,prenatal; Ductus venosus; Hemodynamic phenomena? 静脉导管是胎儿时期连接于脐静脉和下腔静脉之 间的纤细管道。来自胎盘含氧高的血流通过静脉导管 直接到卵圆窝和左房供给心脑等重要器官。随着超声 显像技术的发展，对胎儿静脉导管的血流开始了广泛 的临床研究，其血流波形作为定性的指征用以评价胎 儿的健康状况［1-7］。研究表明，异常的静脉导管血流波 形伴随着母体和胎儿病理情况。本研宄目的在于建立 中晚孕期静脉导管血流波动指数参考范围。 1研宄对象 2002年1月至2008年12月在我院就诊的16?41 孕周的132例孕妇、年龄21?39岁，平均(29.3±3.8)岁。 22周前根据超声测量胎儿生长指标和末次月经确定 孕龄。22周以后根据末次月经确定孕龄。末次月经 不详者根据超声测量确定孕龄。 孕妇以往体健，无烟酒等不良嗜好和慢性疾病