三维彩超对绕颈脐带胎儿宫内缺氧的诊断价值

目的：研究分析三维彩超检查绕颈脐带螺距增加率与宫内缺氧的相关性。方法：选取2011年12月-2013年12月本院收治的脐带绕颈胎儿117例,将胎儿分为缺氧组43例与非缺氧组74例,测量胎儿颈部与游离部脐带螺距,计算增加率,予以无应激试验,分析产后追踪羊水性状,观察胎心率变化状况。结果：在脐带螺距增加率方面,缺氧组为（0.38±0.08）%,非缺氧组为（0.21±0.02）%,两组比较差异有统计学意义（P〈0.05）;在羊水污染与胎心率异常率方面,缺氧组均为23例（53.49%）,非缺氧组均为14例（18.92%）,两组比较差异均有统计学意义（P〈0.05）。此外,与非缺氧组比较,缺氧组胎儿大脑中动脉血流各指标较低,脐动脉血流各指标较高,差异均有统计学意义（P〈0.05）。结论：积极利用三维彩色多普勒超声,可对螺距增加率、血流等进行检测,分析胎儿宫内缺氧状况,为临床早期诊断与治疗提供可行性参考依据。

Study for Pitch Increase Rate of Cord around the Neck and Three-dimensional Colour to Exceed the Intrauterine Hypoxia

Objective： To investigate the three-dimensional color Doppler ultrasound examination of umbilical cord around the neck pitch rate of increase in correlation with intrauterine hypoxia. Method： 117 cases of cord around the neck in our hospital from December 2011 to December 2013 were selected, and were divided into hypoxia group （ 43 cases ） and non- hypoxia group （ 74 cases ）, the fetal umbilical cord and neck with the free portion of the pitch were measure, the rate of increase were calculated, be non-stress test, the amniotic fluid analyzed, postpartum follow traits changes in fetal heart rate condition were observed. Result： The rate of increase in terms of pitch on the umbilical cord, the hypoxia group were （ 0.38 ± 0.08 ） %, and the non- hypoxia group were （ 0.21 ± 0.02 ） %, the difference was statistically significant （ P〈0.05 ） ; in amniotic and fetal heart rate abnormalities, the hypoxia group was 23 cases （ 53.49% ）, the non- hypoxia group was 14 cases （ 18.92% ）, the difference was statistically significant （ P〈0.05 ） . In addition, compared with the non- hypoxic group, fetal middle cerebral artery blood flow in each index of the hypoxia group were lower, umbilical artery of each indicator were higher, the difference were statistically significant （ P〈0.05 ） . Conclusion： The active use of three- dimensional color Doppler ultrasound , umbilical cord around the neck can slice D / W ratio to detect , analyze fetal hypoxia, providing evidence for the feasibility of early diagnosis and treatment.