高压氧治疗对胎儿宫内发育迟缓脑及脐动脉血流速率的影响

目的观察高压氧对胎儿宫内发育迟缓（ＩＵＧＲ）胎儿脑及脐动脉血流速率的影响。方法将４３例伴有多普勒血流异常的ＩＵＧＲ患者分为两组：高压氧组２４例，采用高压氧治疗；氨基酸组１９例，采用氨基酸治疗。测定治疗前后胎儿大脑中动脉（ＭＣＡ）、脐动脉（ＵＡ）血流速率以及ＲＩｍｃａ和ＲＩｕａ的变化，观察妊娠足月时该指标恢复情况以及与新生儿预后的关系。结果高压氧组胎儿ＲＩｍｃａ明显上升，ＲＩｕａ明显下降；足月时，ＲＩｍｃａ、ＲＩｕａ正常转变率７０．８％，与氨基酸组比较．差异有显著性（Ｐ＜０．０５）；持续异常组新生儿低Ａｐｇａｒ评分、小于孕龄儿发生率分别为６０％和８０％，明显高于正常组（Ｐ＜０．０５和Ｐ＜０．０１）。结论高压氧治疗能有效地改善ＩＵＧＲ胎儿异常的脑及脐动脉血流速率，纠正胎儿宫内缺氧，减少低体重儿的发生。

Effect of hyperbaric oxygenation on blood flow velocity of cerebral and umbilical artery in IUGR fetus

Objective To explore the effect of hyperbaric oxygenation(HBO) on blood flow velocity of middle cerebral artery(MCA) and umbilical artery(UA) in IUGR(intra-uterus growth retardation) fetus.Methods 43 IUGR fetuses associated with abnormal blood flow by Doppler were randomly classified to two groups:HBO group and amino-acid group.Group I patients(n=24) were received the amino-acid 250ml(intravenous drip).At pre-and post-treatment,the blood flow velocity of MCA,UA and resistance index of MCA (RImca) and UA(RIua) were examined and calculated.At the same time,relationship between the index restoration of normal newborn and newborn prognosis was observed. Results The RImca and RIua level of HBO fetuses was sharply increasad and decreased respectively after the treatment.The RImca and RIua level of amino-acid group fetuses wasn't as change as the HBO.In normal newborns of pregnancy,the normal transferring rate of RImca and RIua in HBO was 70.8% compared with the amino-acid group(31.6%),there was a significant difference (P<0.05). The incidence of low Apgar score of both groups in persisting abnormal newborns wss 60% and 80% separately.Which was higher than the normal newborns.Conclusion It shows that HBO therapy may improve the abnormal blood flow of MCA and UA, decrease the hypoxidosis and incidence of weightless newborns for IUGR fetuses.