彩色多普勒超声观察胎儿宫内缺氧时氧疗对胎儿-胎盘血流动力学的影响

目的：本文介绍应用彩色多普勒超声技术观察129例胎儿宫内缺氧孕妇氧疗前后的脐动脉及大脑中动脉的血流动力学变化，评价氧疗的临床价值。材料与方法：比较35例宫内生长迟缓（IUGR）胎儿、32例妊高症（PIH）患者胎儿及62例脐带绕颈（UCAN）胎儿氧疗前后的脐动脉及大脑中动脉血流多普勒参数．以脐动脉及大脑中动脉血流阻力指数（RI）为分析指标。结果：IUGR组、重度PIH组氧疗前后胎儿脐动脉血流阻力指数（RIUA）及大脑中动脉血流阻力指数（RIMCA）变化有显著性差异（P〈0．01）；轻中度PIH组氧疗前后胎儿RIMCA及RILCA变化无显著性差异（P〉0．05）；UCAN组氧疗前后胎儿仅RIMCA变化有显著性差异（P〈0．05）。结论：以上数据表明氧疗可明显影响脐动脉及大脑中动脉血流动力学变化，改善胎儿血液循环和供氧。彩色多普勒超声为宫内缺氧胎儿氧疗疗效观察提供了重要依据。

Effect of oxygen treatment on fetal-placental hemodymmics in fetal intrauterine hypoxia monitored by color Doppler ultrasound

Objective： To evaluate the clinical value of oxygen treatment, the color Doppler ultrasound was used to monitor the hemodynamics of umbilical artery, fetal middle cerebral artery of 129 intrauterine hypoxia in fetus prior and after oxygen treatment. Materials and Methods： To compare Doppler parameters of umbilical artery and fetal middle cerebral artery in 35 cases of intrauterine growth retardation （IUGR）, 32 cases of pregnancy induced hypertension （PIH）, and 62 cases of umbilical cord around neck （UCAN） prior and post oxygen treatment, take RIGA, RIMcA and RIMCA/RIUA as analytic target. Results： After oxygen treatment, the RIvA of IUGR cases and serious PIH cases were all significantly decreased, and the RIMCS were all increased（P〈0.01）, however, that of mild to moderate PIH cases were not significantly affected（P〉0.05）. Only the RIMCA was significantly changed in the UCAN cases （P〈0.05）. Conclusion： The data showed that oxygen treatment significantly affected the hemodynamics of umbilical artery and fetal middle cerebral artery, which may improve the fetal circulation and oxygen supply. Color Doppler ultrasound provides an important method for the monitoring of intrauterine hypoxia in fetus after oxygen treatment.