脐动脉联合大脑中动脉检测胎儿宫内缺氧的价值研究

目的 探讨脐动脉(UA)联合大脑中动脉(MCA)检测胎儿宫内缺氧的价值.方法 将2015年2月至2016年2月该院分娩的孕妇349例按照是否存在胎儿宫内缺氧分为观察组(胎儿宫内缺氧组)和对照组(胎儿无宫内缺氧组).将两组的UA、MCA收缩期最高流速与舒张末期流速比(S/D)、搏动指数(PI)、阻力指数(RI)、(S/D)MCA/(S/D)UA、PIMCA/PIUA、RIMCA/RIUA进行比较,统计各指标诊断胎儿宫内缺氧的敏感度、特异度、Youden指数.结果 孕28～35+6周及孕36～41周观察组UA S/D、PI、RI值高于对照组(P＜0.05),而MCA S/D、PI、RI值及(S/D)MCA/(S/D)UA、PIMCA/PIUA、RIMCA/RIUA值低于对照组(P＜0.01).MCA、UA的阻力指标相应比值诊断胎儿缺氧的Youden指数最高.结论 联合使用胎儿UA和MCA阻力指标比值来预测胎儿宫内缺氧的临床价值更高.

Study on value of umbilical artery combined with fetal middle cerebral artery for detecting fetal intrauterine hypoxia

Objective To study the value of umbilical artery(UA)combined with fetal middle cerebral artery(MCA)for detecting fetal intrauterine hypoxia.Methods A total of 349 pregnant women undergoing childbirth in our hospital from February 2015 and February 2016 were divided into the observation group(fetal intrauterine hypoxia group)and control group(normal fetus group)according to the existence of fetal intrauterine hypoxia.Then the systolic peak velocity and end-diastolic velocity ratio(S/D),pulse index(PI),resistance index(RI),(S/D)MCA/(S/D)UA,PIMCA/PIUA,RIMCA/RIUA of UA and MCA were compared between the two groups.The sensitivity,specific degree and Youden index of each index for diagnosing fetal hypoxia were statistically analyzed.Results The S/D,PI and RI values of UA at 28-35+6 pregnant weeks and at 36-41 pregnant weeks in the observation group were higher than those in the control group(P＜0.05),while the S/D,PI,RI value of MCA and(S/D)MCA/(S/D)UA,PIMCA/PIUA and RIMCA/RIUA values were lower than those in the control group(P＜0.01).The resistance index corresponding ratios of MCA and UA for diagnosing fetal hypoxia had the highest Youden index.Conclusion The combined use of fetal UA and MCA resistance index ratios has higher clinical value for predicting fetus intrauterine hypoxia.