摘要
目的:探讨胎心宫缩监护(CTG)计算机分析系统中短变异(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:对1018例产妇进行产前或产时胎心率监护,计算机分析分娩前3563个CTG图形的STV值,并对其中256例取脐带血测定其脐动脉血气pH值,结合分娩时羊水性状和新生儿出生后1minApgar评分情况,分析它们之间的关系。结果:(1)pH<7.20组其STV值为(2.93±1.45)ms,明显低于pH>7.20组[(3.80±1.21)ms;(4.52±1.30)ms],差异有显著性,P<0.05～0.001;(2)新生儿重度窒息组STV值为(2.02±0.63)ms,低于轻度窒息组(2.73±1.14)ms和正常组(4.12s±1.35)ms,差异有显著性,P<0.01～0.001;(3)STV值>3.5ms无窒息发生;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窘迫的敏感指标,与新生儿1minApgar评分、脐带血气pH值有显著相关性;STV<3.5ms对胎儿宫内窒息有较高的临床预测价值。
Objective： To discuss the clinical threshold and significant values of short-term variation in computered CTG analysis system as a new index. Methods： Data were collected from 1018 pregnancies who were all near term and singleton gestation for measurements of 3563 CTG records and outcome. Short-term variation was analyzed by FM Expert computerized system. Umbilical cord blood gas was analyzed at birth on 256 patients. Results： The value of STV （2.93± 1.45） ms in umbilical artery blood gas pH 〈 7.20 group is significantly lower than that （3.80±1.21）ms and （4.52±1.30） ms in pH 〉 7.20 group （P 〈 0.05-0.001）. The value of STV （2.02±0.63） ms in fetal distress group in also significant lower that that （4.12±1.35）ms in normal group （P〈 0.001）. The rate of fetal distress in STV 〉 3.5 ms group is 0. STV 〈 2.0 ms suggests the fetal is becoming asphyxia and the record might be pretetminal. Conclusion： STV is a very significant index to predict fetal asphyxia. It is closely related with 1 min Apgar and umbilical artery blood gas pH. STV 〈 3.5 millisecond is a critical threshold to predict fetal asphyxia.
出处
《岭南急诊医学杂志》
2006年第3期198-199,共2页
Lingnan Journal of Emergency Medicine
关键词
胎心宫缩监护
短变异
宫内窒息
cardiotocography
hort-term variation
fetal asphyxia
