摘要
目的:探讨胎心宫缩监护(cardiotocography,CTG)计算机分析系统中短变异(shorttermvariation,STV)参数的临床界值及意义,评价其对胎儿窘迫的预测价值。方法:2003年7月至2004年8月对1082例产妇进行产前或产时胎心率监护,计算机分析分娩前3787个CTG图形的STV值,并对其中280例取脐带血,了解测定其脐动脉血血气pH值,结合分娩时羊水性状和新生儿出生后1minApgar评分情况进行分析它们之间的关系。结果:pH<7.20组其STV值为(2.72±1.69)ms,明显低于pH7.20～7.25组(3.64±1.02)ms和pH>7.25组(4.29±1.27)ms,差异有显著性意义(P<0.05;P<0.001)。新生儿重度窒息组STV值为(1.80±0.34)ms,低于轻度窒息组(2.58±1.01)ms和正常组(3.92±1.37)ms,差异有显著性意义(P<0.01;P<0.001)。STV值<3.0ms时发生新生儿窒息的例数占新生儿窒息总数的91.38%,提示临床需警惕新生儿窒息的发生。STV值<2.5ms时占60.35%,预示新生儿窒息即将发生或不可避免。当STV值<2.0ms时可能为终末期胎心图表现,预示胎儿即将死亡。结论:STV值是一个判断胎儿宫内情况的敏感指标,与新生儿1minApgar评分、脐动脉血血气pH值有显著相关性;STV<3.0ms对胎儿窘迫有较高的临床预测价值。
Objective:To discuss the clinical threshold and value of short-term variation in computerized CTG analysis system as a new index.Methods:Data were collected from 1082 pregnancies who were all near term and singleton gestation with measurements of 3787 CTG records and outcome. Short-term variation was analyzed by FMExpert computerized system. Umbilical cord blood gas was analyzed at birth in 280 cases.Results:The value of STV(2.72±1.69 ms) in umbilical arterial blood gas pH<7.20 group is significantly lower than that in pH 7.20~7.25 group ( 3.64±1.02 ms) and pH>7.25 group (4.29±1.27 ms) respectively(P<0.05; P<0.001). The value of STV (1.80±0.34 ms) in fetal distress group was also significantly lower than that (3.92±1.37)ms in normal group(P<0.001). The rate of fetal distress in STV<3.0 ms group was 91.38%, which was predictive of fetal hypoxia. And in STV<2.5 ms group the rate was 60.35%, suggesting fetal asphyxia and preterminal status.Conclusion:STV is a very significant index to predict fetal distress. It is closely related with 1 min Apgar and umbilical arterial blood gas pH. STV<3.0 millisecond is a critical threshold to predict fetal distress.
出处
《广州医学院学报》
2005年第2期49-52,共4页
Academic Journal of Guangzhou Medical College
关键词
胎心宫缩监护
短变异
胎儿窘迫
cardiotocography
short-term variation
fetal distress
