摘要
目的 探索联合胎儿心电图（FECG）及无应激实验（NST）在预测胎儿宫内窘迫中的作用。方法选取2012年1～12月因“胎儿宫内窘迫”而剖宫产手术终止妊娠患者107例，其中47例妊娠期糖尿病者列为研究组，60例孕期产检无特殊患者为对照组，回顾性分析相应临床资料，比较2组孕妇临床转归及新生儿出生后结局。结果所有入选病例NST均为无反应型，研究组检出异常FECG24例，FECG异常检出率51．06％，异常FECG表现为胎儿心律失常14例，胎儿FECGQRS波时限增宽及QRS波高电压各5例；对照组检出异常FECG9例，FECG异常检出率15．00％，异常FECG均表现为胎儿心律失常；FECG异常检出率方面，研究组明显高于对照组。FECG异常患者中研究组术中证实胎儿宫内窘迫23例，对照组术中证实胎儿宫内窘迫9例，2组相比差异无统计学意义。联合NST与FECG对胎儿宫内窘迫的判断的灵敏度及特异度依次为89．72％及69．16％。与单纯NST、FECG单一监测结果相比，联合NST与FECG结果能提高判断胎儿宫内窘迫特异度。结论FECG联合NST应用能提高预测妊娠期糖尿病胎儿宫内窘迫准确性。
Objective To explore the function of fetal electrocardiogram （FECG） and non-stress test （NST） in predicting fetal distress for pregnant women with gestational diabetes. Methods A total of 107 consecutive cases received cesarean section due to fetal distress in Jiaxing Women and Children Hospital were retrospectively analyzed from January to December 2012. 47 cases with gestational diabetes were treated as the research group, and the other 60 normal consecutive cases were set as the control group. The two groups were compared in terms of clinical outcomes in pregnant women and follow-up of fetal outcome after birth. Results The results of NST in all cases of the test were non-reactive. 24 cases in the research group were detected with abnormal FECG, which was demonstrated as fetal arrhythmia in 14 cases, widened QRS wave in 5 cases and high voltage in 5 cases, and the abnormal rate in the research group was 51.06%. Meanwhile, 9 cases with fetal arrhythmia in the control group were detected, and the abnormal rate in the control group was 15.00%. 5 cases with widened QRS wave and 5 cases with high voltage, and the abnormal rate in the research group was 51.06%. The abnormal detection rate in the research group was significantly higher than the control group. 23 cases in the research group and 9 cases in the control group were confirmed fetal distress by operation, and there was no significant difference between the two groups. The sensitivity and specificity in cases judged by FECG and NST were 89.72% and 69.16% respectively. Compared with the simple NST or FECG single monitoring results, there was significant difference between the two groups respectively. Conclusions The combination of FECG and NST can greatly improve the specificity of prediction of fetal distress in gestational diabetes.
出处
《中国实用护理杂志》
北大核心
2013年第28期1-4,共4页
Chinese Journal of Practical Nursing
基金
2012年浙江省医药卫生科技计划项目（2012KYB209）
嘉兴市科技局基金资助项目（2012AY1073.1
2012AY1073-6）
