摘要
目的探讨产时胎儿电子监护（electronic fetal monitoring，EFM）图形的数学特征与新生儿酸中毒的关系，以辅助临床评估“不确定”型EFM图形的临床意义。方法回顾性纳入2011年2月4日至12月5日在北京大学第三医院产科自然分娩或产程中转剖宫产的产妇共85例，取分娩前0．5～1h的EFM图，提取数据点，分析其数学特征，包括胎心基线率、单位时间减速区面积（cm^2／min）、减速持续时间比例、单位时间轻中度及重度变异减速的个数。根据分娩后脐动脉血气结果分为酸中毒（n=12）及非酸中毒组（n=73），采用两独立样本t检验和非参数秩和检验比较组间FEM图形的数学特觚的差异。结果酸中毒组减速持续时间比例及单位时间减速区面积分别为0．56±0．17和0．45cm^2／min（0．38～0．79cm^2／min），高于非酸中毒组[分别为0．42±0．14和0．30cm^2／min（0．19～0．41cm^2／min）]，差异均有统计学意义（t=2．889，Z=-2．587，P均〈0．05）。酸中毒组单位时间轻中度及重度变异减速的个数分别为（0．44±0．14）个／min和0．033个／min（0．016～0．062个min），与非酸中毒组[分别为（0．41±0．13）个／min和0．016个／min（0．008～0．033个／min）]比较，差异没有统计学意义（t=1．318，Z=-1．596，P均〉0．05）。结论产时EFM图形中减速持续时间比例及单位时间减速区面积有助于辅助产程是EFM图形的解渎。
Objective To explore the relationship between mathematical characleristics of cardiotocograph in electronic fetal monitoring （EFM） and umbilical blood acidosis, and help to evaluate the clinical significance of ＂indeterminate＂ EFM. Methods A total of 85 vaginal delivery cases （or transfer to caesarean section during labor） hospitalized in Peking University Third Hospital during February 4 to December 5, 2011 was enrolled in this retrospective study. EFM monitored0.5 1 hour before delivery was recorded and the mathematical characteristics as the baseline, deceleration area per unit time （cm^2/min）, deceleration duration ratio and some other variables of EFM were analyzed. All cases were divided into acidosis （n=12） and non acidosis group （n=73） based on the umbilical blood gas results. Rank sum test or l-test were used to compare the difference on mathematical characteristics between these two groups. Results The deceleration duration ratio and deceleration area per unit time in acidosis group were 0.56±0. 17 and 0.45 cm^2/min （0.38-0.79 cm^2/ min）, which were higher than those in non-acidosis group [0.42±0. 14 and 0.30 cm^2/min （0. 19-0.41 cm^2/min）], the differences were statistically significant （t=2.889, Z=-2. 587, both P〈 0.05）. There were no statistically significant differences in the number of mild variable deceleration and severe deceleration per unit time hetween acidosis group and non acidosis group [（0.44 ± 0. 14 ）/min vs （0. 41±0.13）/min, t=1. 318, P〉0.05; 0.033/min （0.016-0.062/min） vs 0.016/min （0.008-0. 033/min）, Z=-1. 596, P〉0.05]. Conclusions The deceleration duration ratio and deceleration area per unit time can be used to assist the interpretation of ＂indeterminate＂ EFM.
出处
《中华围产医学杂志》
CAS
北大核心
2013年第11期656-659,共4页
Chinese Journal of Perinatal Medicine
关键词
胎心分娩力描记法
心率
胎儿
酸中毒
胎血
血气分析
算法
Cardiotocography
Heart rate, fetal
Acidosis
Fetal blood
Blood gas analysis
Algorithms
