妊娠晚期联合应用无负荷试验与多普勒脐动脉血流速度测定对胎儿预后的评价.docVIP

???? 妊娠晚期联合应用无负荷试验与多普勒脐动脉?血流速度测定对胎儿预后的评价 ???? ???? 【摘　要】　目的　探讨联合仪器监护判断胎儿预后的价值。方法　联合应用胎心无负荷试验(NST)及多普勒脐动脉血流速度测定对673例妊娠晚期孕妇进行观察。结果　NST可疑型和无反应型组S/D≥3者发生率比反应型组明显增高，在S/D≥3组中羊水污染、1分钟Apgar评分≤7分及低体重儿发生率均明显高于S/D3组(P0.005)，NST可疑或无反应型与S/D比值≥3预测胎儿预后的特异性、敏感性、阳性预测值和阴性预测值分别为77.86%、83.65%、40.85%、96.30%与98.24%、28.85%、75.00%、88.31%，NST可疑或无反应型联合S/D比值≥3的特异度、敏感度、阴性预测值和阳性预测值为99.30%、28.85%、88.42%、88.24%。结论　NST与多普勒脐动脉血流速度测定联合应用可以提高胎儿宫内缺氧状态的诊断，为临床及时纠正宫内缺氧提供了可靠依据。【关键词】　胎心无负荷试验(NST)　脐动脉血流速度　胎儿预后　晚期妊娠 The use of fetal nonstress test combined with fetal umbilical artery doppler velocimetry for assessment of fetal prognosis in late pregnancy Li Hongyan，Wang Xietong，Xing Guangkun（Shandong Provicial Hospital,Jinan 250021） 【Abstract】　Objective　To discuss the values of combined instrumental monitor for judging fetal prognosis in late pregnancy.Methods　Fetal nonstress test(NST)combined with fetal umbilical artery doppler velocimetry were used in 637 late pregnant women.Results　The incidence of systolic-diastolic ratio(S/D)≥3 in the suspicious and non-reactive NST group is significantly higher than that in the reactive one.The incidence of meconium,1-min Apgar score≤7 and low birth weight infant in S/D≥3 group is significantly higher than that in the S/D3 group(P0.005).To predicate fetal adverse outcome,suspicious or non-reactive NST has a specificity of 77.86%,a sensitivity of 83.65%,a positive and negative predictive values of 40.85% and 96.30%,respectively.S/D≥3 has a specificity of 98.24%,a sensitivity of 28.85%,a positive and negative predictive values of 75.00% and 88.31%,respectively.Conclusion　The use of fetal nonstress test combined with fetal umbilical artery doppler velocimetry would improve the diagnosis for fetal anoxia,and give a reliable information to treat fetal anoxia for clinicians.【Key words】　Nonstress test　Umbilical artery flow velocity　Fetal prognosis　Late pregnancy 　　胎心率监护作为判断胎儿宫内健康状况的监测方法，在国内外已普遍应用于临床，其中NST作为常规检查，从中筛选异常病例用以判断胎儿宫内安危，但由于多方面原因，其假阳性率较高。近年来多普勒脐动脉血流速度测定技术应用于临床，为