彩色多普勒血流动力学指标预测胎儿缺氧的价值

目的:预测胎儿宫内缺氧。方法:应用彩色多普勒超声检测171例晚期妊娠胎儿脐动脉(UMA)、大脑中动脉(MCA)、大脑前动脉(ACA)、肾动脉(RA)的血流速度波形,产后随访新生儿结局。结果:正常组胎儿UMA、MCA、ACA、RA的阻力指数(R I)、搏动指数(PI)及收缩期峰值流速(A)与舒张末期流速(B)比值(A/B)与孕龄成负相关;异常组胎儿R I、PIMCA/R I、PIUMA<1或R I、PI ACA/R I、PIUMA<1提示缺氧,MCA、ACA舒张期的血流从早期缺氧的增加状态到恢复正常提示胎儿缺氧进入晚期;UMA、RA的血流测值增高,测值与胎儿缺氧程度成正相关。结论:产前监测胎儿UMA、MCA、ACA、RA的血流指数,可以了解胎儿胎盘循环,胎儿颅脑循环及周围循环状态,预测胎儿宫内缺氧状况。

The value of the Colour Doppler blood dynamics indices in predicting the fetal hypoxia

Objective:To predict the fetus intrauterine hypoxia.Methods:The fetal blood velocity waveforms were examined with Colour Doppler ultrasonography in 171 later pregnancy,including fetus umbilical artery(UMA),middle cerebral artery(MCA),anterior cerebral artery(ACA) and renal artery(RA).These figures of the newborn baby were visited after birth.Results:In the normal group,the resistance index(RI),pulsative index(PI) and ratio(A/B) of flow velocity in peak systole(A) to later diastole(B) of UMA,MCA,ACA and RA were negative correlations with ages of women who cherish fetus.In the abnormal group,the fetus' RI,PI MCA/RI,PI UMA<1 or RI,PI ACA/RI,PI UMA<1 pointed out hypoxia.The diastole blood flow of the fetus' MCA,ACA pointed out that the fetus hypoxia was in the later period from the increasing state of the early stage hypoxia to returning to normal.The blood flow data of UMA and ACA were increased and the data were positive correlation with degree of fetal hypoxia.Conclusion:Before birth,monitoring the blood flow data of UMA,MCA,ACA and RA of the fetus can supply important information about the fetal placenta circulation,the fetal brain circulation and the fetal surrounding circulation and can predict the fetal intrauterine hypoxia.