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目的探讨胎儿宫内输血临床应用的安全性及监测指标选择。方法收集行宫内输血的孕妇共6例,对6例宫内输血孕妇的大脑中动脉血流速度(MCA-PSV)、大脑中动脉血流阻力(MCA-RI)、脐动脉血流速度(UA-PSV)、脐动脉血流阻力(UA-RI)进行监测,比较输血前后MCA-PSV、MCA-RI、UA-PSV、UA-RI的差值。结果 6例宫内输血病例中,3例顺利分娩,2例死胎引产,1例新生儿因肺发育不良,呼吸窘迫死亡。输血前后,MCA-PSV差值与UA-RI的差值存在统计学差异(P<0.05),MCA-RI与UA-PSV的差值无统计学差异(P>0.05)。结论严格掌握手术适应证是宫内输血成功的关键,MCA-PSV及UA-RI是预测宫内输血预后的良好指标。
Objective To explore the clinical application of fetal intrauterine transfusion safety and monitoring indicators selection. Methods Six pregnant women who underwent intrauterine transfusion were enrolled in this study. The blood flow velocity (MCA-PSV), MCA-RI, UA -PSV) and umbilical artery blood flow resistance (UA-RI). The differences of MCA-PSV, MCA-RI, UA-PSV and UA-RI before and after transfusion were compared. Results Among the 6 cases of intrauterine transfusion, 3 cases delivered successfully, 2 cases of stillbirth induced labor, and 1 newborn died of respiratory distress due to pulmonary dysplasia. The difference of MCA-PSV and UA-RI before and after blood transfusion had statistical difference (P <0.05). There was no significant difference between MCA-RI and UA-PSV (P> 0.05). Conclusion Strict indications of surgical indications are the key to successful intrauterine transfusion. MCA-PSV and UA-RI are good predictors of intrauterine blood transfusion prognosis.