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1、联合胎心监护和脐血流测定监测围产儿低氧?856?四川医学2011年6月第32卷(第6期)SichuanMedicalJournal,2011,go1.32,No.6联合胎心监护和脐血流测定监测围产儿低氧刘欣,梁永,胡小萍,张娟(解放军第161医院妇产科,湖北武汉430010)论着【摘要】目的探讨联合应用中央型电子胎心监护与脐动脉血流速度测定监测围产儿低氧的临床价值.方法对孕晚期产妇529例.行胎心监护,脐血流S/D值测定,脐动脉血气分析,并记录产时羊水情况,新生儿体重及Apgar评分.结果胎心监护异常82例,脐血流S/D值I>3
2、者72例.胎心监护异常组新生儿预后不良31例,明显高于胎监正常组;脐动脉血气分析显示,两组pH值,PCO2,P02均差异有统计学意义.脐血流S/D值≥3者有36.1%新生儿预后不良,脐血流S/D值与新生儿窒息,羊水粪染,低体重儿密切相关;且脐血流S/D值/>3者其pH值,PO均小于S/D值<3者(P<0.O1).胎心监护,脐血流测定的阳性预测率分别为37.8%,36.1%,胎心监护联合脐血流测定的阳性预测率高达72.4%,明显高于单项检查预测值.结论联合应用胎心监护与脐血流测定对于监测围产儿低氧,减少新生儿窒息,改善
3、围产儿预后具有积极的临床意义.【关键词】脐血流;胎心监护;围产儿;缺氧【中图分类号】R714.7【文献标识码】A【文章编号】1004-0501(2011)06-0856-03Applicationoffetalheartratemonitoringcombinedwithumbilicalarteryflowvelocimetryininspectingperinatalfe-talhypoxia.LIUXJn,HANGy0,HUXiao-ping,eta1.The161"Ho~italofPLA,Wuhan,Hubei430010,
4、China【Abstract】ObjectiveToinvestigatetheclinicalvalueoffetalheartratemonitoringcombinedwithumbilicalarteryflowvelocimetryinpredictingfetalhypoxia.MethodsAll529pregnantwomenwereenrolledtobedetectedfetalheartratemonitoringandumbilicalarteryflowveloeimetry.Umbilicalvenousb
5、loodgasanalysis,amniotiefluid,weightandApgarScoreofnewbornwerecollected.ResultsTherewere82casesofabnormalfetalheartrateand72easesofS/D≥3.Therewere3lfetuseswithbadoutcomeinabnormalheartrategroup.ThebloodgasanalysisdisplayeddifferentvalueofpH,PCO2andPO2betweentwogroups.Th
6、erewere36.1%ofnewbornswithbadoutcomeinS/Dt>3group.AndthevalueofpH,PO2ofcasesinS/D≥3groupwerelessthanthatofS/D<3group.Thepositivevalueofabovesingleexaminationwas37.8%and36.1%respectively.Whilethepositivevalueofcombinedexaminationwas72.4%.ConclusionFeta1heartratemon
7、itoringcombinedwitllumbilicalarteryflowvelocimetryhavegreatuseininspectingperinatalfetalhypoxiaanddeceleratingneonatalasphyxia.【Keywords】umbilicalarteryflowvelocimetry;fetalheartratemomto6ng;fetalprognosis;porinatalfetalhypoxia临床上如何做到早期诊断和及时治疗胎儿宫内低氧,对于改善围产儿的预后影响极大.目前临床用
8、于监测胎儿宫内情况的方法主要有电子胎心监护及脐血流测定,本文通过研究探讨联合应用两种方法预测围产儿低氧隋况,评价其对改善围产儿预后的意义,报告如下.1资料与方法1.1一般资料:选择2008年1月一2010年3月我院住院分
