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1、胎儿宫内窘迫采用彩色多普勒与三维超声联合诊断的临床价值［摘要］目的探讨胎儿宫内窘迫采用彩色多普勒与三维超声联合诊断的临床价值。方法对38例经产后确诊为胎儿宫内窘迫的孕妇的产前检查结果进行回顾性分析，通过对其胎儿心率、脐动脉收缩期峰流速以及舒张末期流速之比(S/D)、阻力指数(RI)、大脑中动脉RI、搏动指数(PI)值等彩色多普勒检测指标进行分析，并结合三维超声重建图像，观察胎儿的胎动、脐带形态、绕颈周数以及空间转向等情况。依据脐带绕颈情况对孕妇进行分组，对比各组间的RI及S/D值。结果胎儿心率异常、胎动异常以及脐动脉、大脑中动脉血流参数异常是判定胎儿冇
2、无缺氧和缺氧程度的主要指标。而脐带缠绕、羊水过少是导致胎儿宫内窘迫的主要原因。彩色多普勒联合三维超声诊断结果与产后结果的符合率为98.0%。脐带绕颈周数不同的患儿，其RI及S/D值比较冇统计学意义(P〈0.05)。结论彩色多普勒与三维超声联合诊断能够准确及时地对胎儿宫内窘迫原因和程度进行诊断，为临床观察产程，分娩方式和时机的选择提供可靠的参考依据，对提高胎儿生存质量，预防和降低围产儿死亡率以及优生优育均具有极高的临床指导意义。［关键词］彩色多普勒；三维超声；胎儿宫内窘迫；宫内缺氧［中图分类号］R445.1；R714.5［文献标识码］B［文章编号］209
3、5-0616(2016)09-174-04[Abstract]ObjectiveToresearchtheclinicalvalueofcolordoppercombinedwiththree-dimensionalultrasoundinfetaldistress.Methods38casesofprenatalexaminationwerediagnosedaspostpartumfetaldistressinpregnantwomenwereanalyzedretrospectively.Throughanalyzedfetalheartrate
4、,umbilicalarterypeaksystolicvelocityanddiastolicvelocityratio(S/D),resistanceindex(RT),middlecerebralarterypulsati1ityindexvalue(PI)ofthechildren,andcombinedwith3Dultrasoundimagereconstruction,observedfetalmovement,umbilicalcordaroundneckshape,andspatialturnetc.Accordingtotheumb
5、ilicalcordaroundtheneck,groupedforpregnantwomen,andcomparedthevalueofRIandS/D.ResuItsFetalheartrateabnormalities,abnormalfetalmovementandumbilicalartery,middlecerebralarterybloodflowparametersabnormalityweredeterminingprenatalhypoxicandanoxicdegreeofmainindexes.Andtheumbilicalco
6、rdandoligohydramnioswasamajorcauseoffetaldistress.ThecoincidencerateofcolorDopplercombinedwiththree-dimensionalultrasounddiagnosisandpostnataloutcomewas98.0%,thereweresignificantdifferencesbetweentheRTandtheS/Dvalueindifferentumbilicalcordaroundneckofchildren,andthedifferenceswe
7、restatisticallysignificant(P<0.05)•ConelusionColordopplercombinedwiththree-dimensionalultrasoundcandiagnoseaccuratelyandtimelyforthecauseandextentoffetaldistress,toprovideareliablereferenceforclinicalobservationofbirthprocess,thetimingandmodeofdelivery.Toimprovethequalityoflifeo
8、fthefetustoprevent,reducetheperinatalmortalitya
