摘要
目的探讨孕晚期胎儿脐动脉血流参数变化与Tei指数评估胎儿心室功能在预测胎儿宫内窘迫中的价值。方法选取37~42孕周的单胎孕妇50例,用超声诊断仪对胎儿进行常规检查,彩色多普勒监测胎儿脐动脉的S/D、阻力指数、搏动指数及心脏Tei指数。胎儿娩出后立即对胎儿进行脐血血气分析并进行1 min Apgar评分。结合分娩过程中羊水污染、胎心率变异的情况、胎儿出生体重及脐动脉血气分析结果进行评估。结果1)本组50例胎儿中正常26例,胎儿窘迫24例;2)窘迫胎儿的脐动脉血流动力学指标(S/D、RI、PI)较正常胎儿明显增高;3)窘迫胎儿心脏Tei指数较正常胎儿增高;4)窘迫胎儿娩出后1min Apgar评分及血气分析结果均低于正常胎儿;5)脐动脉S/D及RI、左右心室的Tei指数的灵敏度和特异度相对较高,其约登指数均在0.6以上,在预测胎儿是否存在宫内窘迫方面有意义。结论Tei指数敏感、准确,不受年龄、心室几何形态、心率及孕龄的影响,可预测胎儿宫内缺氧的情况,为临床分娩时机及分娩方式提供参考价值,降低了围产儿的死亡率。
Objective The purpose of this study is to investigate the value of color Dopple ultrasound in dectection of umbilical artery and Tei index in prediction of late trimester fetal growth restriction.Methods Fifty fetuses between 37 and 42 weeks of gestation were measured for UA,pulsatility index(PI),resistance index(RI)and the peak-systolic/dias-tolic ratio(S/D)and Tei index by color Doppler ultrasonography.Blood gas analysis and Apgar score were conducted after fetal childbirth.Results 1)In this study,there were 26 cases of normal fetuses and 24 cases of fetal distress;2)The distress of fetal umbilical artery hemodynamics indexes(S/D,RI,PI)was significantly higher than normal fetuses;3)The distress of fetal cardiac function Tei index was higher than normal fetuses;4)After childbirth,fetal distress 1 min apgar score and blood gas analysis results were lower than those of normal fetuses;5)Fetal umbilical artery and cardiac function Tei index had higher sensitivity,specificity and Youden index.Conclusion Because Tei Index is highly sensitive,accurate,and not affected by age,ventricular geometry,heart rate and the influence of gestational age and other characteristics,it can predict fetal intrauterine hypoxia,provide reference value for clinical delivery timing and manner of delivery,and reduce the mortality rate of perinatal.
作者
王燕
陈春强
曹子洋
李军
WANG Yan;CHEN Chunqiang;CAO Ziyang;LI Jun(Department of Ultrasonography, The Second People`s Hospital of Liaocheng, The Second Hospital of Liaocheng Affiliated to Shandong First Medical University, Liaocheng 252600, P.R.China;Department of Echocardiology, The Second People`s Hospital of Liaocheng, The Second Hospital of Liaocheng Affiliated to Shandong First Medical University, Liaocheng 252600, P.R.China)
出处
《医学影像学杂志》
2021年第6期1047-1050,共4页
Journal of Medical Imaging
