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目的:应用三维彩色多普勒超声检测绕颈脐带螺距增加率,探讨胎儿宫内缺氧与之相关性。方法:对我院115例脐带绕颈胎儿颈部及游离部脐带螺距进行测量,计算增加率。依据胎儿监护将胎儿分为缺氧组(42例)和非缺氧组(73例)。胎儿行无应激试验,产后追踪羊水性状及产程中胎心率变化。结果:缺氧组和非缺氧组脐带螺距增加率分别为(0.37±0.07)%、(0.20±0.01)%,两者比较差异有高度统计学意义(P<0.01);缺氧组脐动脉血流收缩压与舒张压的比值(S/D)为(3.23±0.08)、羊水污染及胎心率异常的例数(23例,占54.8%)与非缺氧组脐动脉血流S/D(2.27±0.11)、羊水污染及胎心率异常的例数(13例,占17.8%)比较,差异均有统计学意义(均P<0.05)。结论:三维彩色多普勒超声检测绕颈脐带螺距增加率可及时提示胎儿宫内缺氧,为临床尽早诊断和治疗提供帮助。
OBJECTIVE: To investigate the correlation between fetal hypoxia and three-dimensional color Doppler ultrasonography in detecting the rate of increase of cervical umbilical cord pitch. Methods: 115 cases of umbilical cord around the neck in our hospital neck and free umbilical cord screw pitch measurements were made to calculate the rate of increase. The fetus was divided into hypoxia group (n = 42) and non-hypoxia group (n = 73) according to fetal monitoring. Fetal non-stress test, postnatal follow-up amniotic fluid trait and fetal heart rate changes in labor. Results: The rates of increase of umbilical cord pitch were (0.37 ± 0.07)% and (0.20 ± 0.01)% in hypoxia group and non-hypoxia group respectively. There was a statistically significant difference between the two groups (P <0.01) The ratio of systolic blood pressure to diastolic blood pressure (S / D) was (3.23 ± 0.08), the number of amniotic fluid contamination and abnormal fetal heart rate (23 cases, 54.8% D (2.27 ± 0.11), amniotic fluid contamination and abnormal fetal heart rate (13 cases, 17.8%), the differences were statistically significant (all P <0.05). CONCLUSION: Three-dimensional color Doppler ultrasound can detect the hypoxia in fetal intrauterine organism promptly around the increase rate of umbilical cord pitch, which can be helpful for early clinical diagnosis and treatment.