彩色多普勒监测妊娠期高血压患者子宫动脉及胎儿脐动脉血流的临床分析

目的:探讨妊娠期高血压疾病(HDCP)患者胎儿脐动脉及子宫动脉的血流动力学变化,评价彩色多普勒血流显像技术在HDCP上的使用价值.方法:应用彩色多普勒检测180例正常晚期妊娠和150例HDCP患者胎儿脐动脉的收缩末期最大血流速度和舒张末期最大血流速度之比(S/D)、搏动指数(PI)、阻力指数(RI)及子宫动脉的S/D、PI、RI、血管直径(D),同时观察胎儿宫内发育情况如双顶径、股骨长度、胎儿体重,并记录新生儿出生体重、1min阿氏评分及胎儿窘迫、FGR、低体重儿的发生率.结果:HDCP组脐动脉S/D、PI、RI值均高于对照组,HDCP组子宫动脉的S/D、PI、RI值也均高于对照组,血管直径则小于对照组,差异有显著统计学意义(P＜0.05).将HDCP 患者分为脐动脉S/D≥3和S/D＜3两组比较其妊娠结局,前者1min阿氏评分＜7分、胎儿窘迫、IUGR、低体重儿的发生率均高于后者,差异有显著统计学意义(P＜0.05).结论:HDCP患者存在子宫-胎盘、胎盘-胎儿循环障碍,子宫动脉及脐动脉阻抗增高、血供不足,这些病理生理变化与不良妊娠结局相关.彩色超声多普勒可以检测HDCP患者子宫动脉、脐动脉血流动力学变化,在预测HDCP病情发展程度和预测围生儿结局方面有重要的临床价值.

Clinical Monitoring Gravidity Hypertension Collecting the Patient Womb Arterial and the Embryo Navel Arterial Blood Stream Synthetically Analyses Color Doppler

Objective: To study changes on hemodynamics of fetal umbilical artery and uterine artery minute,to evaluate the utility of color doppler blood flow visualize technology in HDCP.Method: Color doppler blood flow visualize technology was used to defect the systolic/diastolic(S/D) ratio and pulsatility indexes(PI),and resistance indexes(RI) of fetal umbilical artery and to defect the S/D,PI,RI and artery diameter of uterine artery in 180 normal late pregnancies and 150 HDCP cases.Study intrauterine growth of the fetus by measurement of fetal biparietal diameter(BPD),femur length(FL),embryo's weight,the birth weight,Apgar score at 1 minute,and the ratio of fetal distress,intrautering growth retardation(IUGR),low weight babies.Result: The S/D,PI,RI of fetal umbilical artery in HDCP were higher than those of controls.The S/D,PI,RI of uterine artery of controls.Artery diameter was smaller in controls,the difference was signifiant compared with HDCP,S/D>3 group and S/D<3 group.Compered there outcome of pregnant.The ratio of Apgar score at 1 minutes<7,fetal distress,FGR,low weight babies in S/D<3 group.the difference was signifiant(P<0.05).Two groups were divided among HDCP,S/D>2.5 group.The difference was signifiant(P<0.05).Conclusion: There was disturbance of uterine-placenta and placenta-fetal circulation.The increase of uterine artery stream and umbilical artery stream and insufficient blood supply is related to abnormal pregant.color Dopper Can Defect the hemodynamics of fetal umbilical artery and uterine artery in HDCP.It's important to assess HDCP and perinatal outcome.