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目的探讨异常多普勒超声血流频谱在晚孕重度子痫前期围产儿结局中的价值。方法选取重度子痫前期患者120例,产前应用多普勒超声检测异常血流频谱:脐动脉舒张期血流消失或反向、子宫动脉舒张早期切迹、静脉导管a波消失或反向、脐静脉搏动。随访和记录围产儿结局,应用多因素Logistic回归分析,分析异常血流频谱和围产儿结局情况的关系。结果静脉导管a波消失或反向是围产儿死亡的独立危险因素(OR=880.00),双侧子宫动脉舒张早期切迹是围产儿入新生儿重症监护室的独立危险因素(OR=98.67),脐动脉舒张期血流消失或反向是发生宫内生长受限的独立危险因素(OR=11.00)。结论发生脐动脉舒张期血流反向时,应积极终止妊娠,以免静脉血流频谱异常而发生围产儿死亡。
Objective To investigate the value of abnormal Doppler ultrasound flow spectrum in perinatal outcome of severe preeclampsia in late pregnancy. Methods 120 cases of severe preeclampsia were selected. Prenatal application of Doppler ultrasound to detect abnormal blood flow spectrum: umbilical artery diastolic blood flow disappeared or reversed, uterine artery early diastolic notch, a catheter disappeared or reversed, Umbilical vein pulsation. Follow-up and record of perinatal outcome, the use of multivariate Logistic regression analysis of abnormal blood flow spectrum and the relationship between the outcome of perinatal children. Results The disappearance or reverse of the a-wave of the venous catheter was an independent risk factor for perinatal death (OR = 880.00). The early diastole of bilateral uterine artery was an independent risk factor for neonatal intensive care unit (OR = 98.67) Umbilical artery diastolic blood flow disappeared or reversed is an independent risk factor for intrauterine growth restriction (OR = 11.00). Conclusions When diastolic flow of umbilical artery is reversed, pregnancy should be terminated actively so as to avoid perinatal death due to abnormal spectrum of venous flow.