胎心率监护计算机分析在临床的应用

目的:探讨胎心率监护计算机分析和目测分析的优缺点及对围产儿结局的预测价值。方法:分析了2003年5月～2004年2月3010份胎心率图型中,长变异各型相对应的短变异数值及361份胎心率图型的计算机分析和目测分析结果预测围产儿结局的敏感度和特异度。结果:NST的计算机分析和目测分析的结果对围产儿结局都有预测作用,但计算机分析的灵敏度和特异度(分别为82%和30%)均高于目测分析(分别为74.5%和26.7%)。计算机分析需要的无负荷试验(NST)监护时间为(14.22+5.69)min,目测分析需要的监护时间为(15.45±5.77)min,有显著性差异(P=0.000)。短变异与长变异的各型之间呈正相关(P=0.000)。结论:应用Sonicaid System8002计算机分析胎心率图型较之目测分析对胎儿宫内窘迫有更好的预测作用,还能缩短产前监护时间,其引入的一个新参数——短变异,能定量反映胎心率基线变异。

Analysis of Computerized Antenatal Fetal Heart Rate Recordings

Objective:To explore the value of computerized antenatal fetal heart rate recording as a predictor of prenatal outcome.Methods:Data were collected from May 2003 to Feb 2004 for measurements of FHR variables(3010 records).Detailed analyses were made on 361 records.Results:Perinatal outcome was correlated with computerized antenatal fetal heart rate analysis and visual analysis (P=0.035 and 0.048 respectively).The sensitivities and specificities of computerized antenatal fetal heart rate analysis were 82% and 30%. The sensitivities and specificities of visual antenatal fetal heart rate analysis were 74.5% and 26.7%.The H-IR monitoring time of computerized rate analysis and visual analysis were 14.22±5.69 minutes and 15.45±5.77 minutes respectively.Short-term variation was related to visual long-term variation(P=0.000).Conclusion:Computerized antenatal fetal heart rate analysis is a better predictor of perinatal outcome than visual analysis. Short-term variation could quantitate FI-IR variation.