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目的:探讨胎心率监护计算机分析和目测分析的优缺点及对围产儿结局的预测价值。方法:分析了2003年5月～2004年2月3010份胎心率图型中,长变异各型相对应的短变异数值及361份胎心率图型的计算机分析和目测分析结果预测围产儿结局的敏感度和特异度。结果:NST的计算机分析和目测分析的结果对围产儿结局都有预测作用,但计算机分析的灵敏度和特异度(分别为82%和30%)均高于目测分析(分别为74.5%和26.7%)。计算机分析需要的无负荷试验(NST)监护时间为(14.22+5.69)min,目测分析需要的监护时间为(15.45±5.77)min,有显著性差异(P=0.000)。短变异与长变异的各型之间呈正相关(P=0.000)。结论:应用Sonicaid System8002计算机分析胎心率图型较之目测分析对胎儿宫内窘迫有更好的预测作用,还能缩短产前监护时间,其引入的一个新参数——短变异,能定量反映胎心率基线变异。
Objective: To investigate the advantages and disadvantages of computer analysis and visual analysis of fetal heart rate monitor and the predictive value of perinatal outcome. Methods: From May 2003 to February 2004, 3010 fetus heart rate patterns were analyzed. Computer analysis and visual analysis of 361 fetus heart rate patterns were performed to predict the short-term variability of the long-term variability, Sensitivity and specificity of outcome. RESULTS: The results of computerized and visual analysis of NST had predictive effects on perinatal outcome, but the sensitivity and specificity of computerized analysis (82% and 30%, respectively) were higher than those of visual analysis (74.5% and 26.7%, respectively) ). The NST monitoring time required by computer analysis was (14.22 + 5.69) min and the monitoring time needed for visual analysis was (15.45 ± 5.77) min, with significant difference (P = 0.000). There was a positive correlation between short and long variations (P = 0.000). CONCLUSIONS: The Socardid System8002 computer-based analysis of fetal heart rate patterns has a better predictive value for fetal distress than visual analysis, and also shortens the time of prenatal care. A new parameter introduced, short variations, can be quantitatively reflected Fetal heart rate baseline variability.