發(fā)布時(shí)間：2018-02-20 19:41

  本文關(guān)鍵詞： 高危妊娠 臍動(dòng)脈 子宮螺旋動(dòng)脈 不良妊娠結(jié)局　出處：《山西醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：通過彩色多普勒超聲聯(lián)合監(jiān)測晚孕期高危妊娠患者胎兒臍動(dòng)脈(umbilical artery, UA)及子宮螺旋動(dòng)脈(spiral artery,SA)的血流參數(shù)指標(biāo),來探討晚孕期高危妊娠胎兒臍動(dòng)脈、子宮螺旋動(dòng)脈血流動(dòng)力學(xué)的變化,以及二者聯(lián)合監(jiān)測對預(yù)測圍產(chǎn)兒結(jié)局的臨床應(yīng)用價(jià)值。 方法：收集整理160例于2013年5月-2014年2月在山西省婦幼保健院產(chǎn)前檢查的單胎晚期妊娠婦女為研究對象,分為兩組,其中高危妊娠組80例,年齡24-42歲、孕周37-42周,正常妊娠組80例,年齡25-34歲、孕周37-41周,先進(jìn)行產(chǎn)科超聲的常規(guī)檢查項(xiàng)目以除外胎兒發(fā)育方面的畸形,主要包括確定胎位,測量胎兒雙頂徑、頭圍、腹圍、股骨長等生長指標(biāo)、以及測量胎心率、羊水量等,然后再應(yīng)用彩色多普勒超聲對胎兒的臍動(dòng)脈及母體子宮螺旋動(dòng)脈的血流進(jìn)行檢測,分別測量以下血流參數(shù)：收縮期峰值速度與舒張期末速度之比值(systolic/diastolic,S/D阻力指數(shù)(resistance index,RI)及搏動(dòng)指數(shù)(pulsatility index,PI),并對高危妊娠組及正常妊娠組所測得的各個(gè)參數(shù)及圍產(chǎn)兒結(jié)局進(jìn)行分析研究。統(tǒng)計(jì)學(xué)分析：采用SPSS16.0統(tǒng)計(jì)軟件進(jìn)行分析,各組測定結(jié)果以均數(shù)±標(biāo)準(zhǔn)差(x±s)表示,組間均數(shù)比較采用t檢驗(yàn),計(jì)數(shù)資料率的比較行χ2檢驗(yàn),P0.05為差異有統(tǒng)計(jì)學(xué)意義。 結(jié)果：①高危妊娠組胎兒臍動(dòng)脈及子宮螺旋動(dòng)脈血流S/D、RI、PI值高于正常妊娠組,差別有統(tǒng)計(jì)學(xué)意義(P0.05)；②80例高危妊娠組中圍產(chǎn)兒結(jié)局異常的有19例,發(fā)生率為23.75%,80例正常妊娠組中圍產(chǎn)兒結(jié)局異常的僅有3例,發(fā)生率為0.38%,高危妊娠組圍產(chǎn)兒結(jié)局異常的發(fā)生率明顯高于正常妊娠組,差別有統(tǒng)計(jì)學(xué)意義(P0.05)；③高危妊娠組中當(dāng)胎兒臍動(dòng)脈和子宮螺旋動(dòng)脈S/D值均高于正常范圍者有15例,其中圍產(chǎn)兒結(jié)局不良者有12例,占80.00%,不良妊娠結(jié)局發(fā)生率明顯高于胎兒臍動(dòng)脈和子宮螺旋動(dòng)脈S/D值單獨(dú)異常組,差別有統(tǒng)計(jì)學(xué)意義(P0.05)。 結(jié)論：妊娠晚期彩色多普勒超聲監(jiān)測胎兒臍動(dòng)脈、子宮螺旋動(dòng)脈的血流狀態(tài),對預(yù)測妊娠結(jié)局的發(fā)生有臨床價(jià)值；二者聯(lián)合監(jiān)測比單獨(dú)監(jiān)測胎兒臍動(dòng)脈或子宮螺旋動(dòng)脈對預(yù)測高危妊娠胎兒不良結(jié)局更有價(jià)值,監(jiān)測子宮螺旋動(dòng)脈可以作為臍動(dòng)脈預(yù)測不良妊娠結(jié)局的補(bǔ)充。
[Abstract]:Objective: to study the blood flow parameters of fetal umbilical artery (UAV) and uterine spiral artery (spiral artery SAA) in high risk pregnancy patients during late pregnancy by color Doppler ultrasound (CDFI). Changes of uterine helical artery hemodynamics and clinical value of combined monitoring in predicting perinatal outcomes. Methods: one hundred and sixty pregnant women with single pregnancy, who were examined in Shanxi Maternal and Child Health Hospital from May 2013 to February 2014, were divided into two groups: 80 cases in high-risk pregnancy group, aged 24-42 years, 37-42 weeks of gestational age. 80 cases of normal pregnancy group, aged 25-34 years and 37 to 41 weeks of gestational age, underwent routine obstetric ultrasound examination to exclude fetal developmental malformations, including determination of fetal position, measurement of fetal biparietal diameter, head circumference, abdominal circumference, femur length and other growth indicators. The fetal heart rate and amniotic fluid were measured, and then the fetal umbilical artery and the maternal uterine spiral artery blood flow were detected by color Doppler ultrasound. The following parameters were measured: ratio of peak systolic velocity to end-diastolic velocity, resistance index (RI) and pulsatility index (Pi) of S / D resistance index and pulsatility index (Pi). The parameters and perinatal outcomes of high-risk pregnancy group and normal pregnancy group were evaluated. Statistical analysis: use SPSS16.0 statistical software to analyze, The results of each group were expressed as mean 鹵standard deviation (x 鹵s). T test was used to compare the mean among the groups, and 蠂 2 test was used to compare the count data rate. There was significant difference between the two groups (P0.05). Results the blood flow of fetal umbilical artery and uterine spiral artery in the high risk pregnancy group was significantly higher than that in the normal pregnancy group. There were 19 cases of abnormal perinatal outcome in the 280 cases of high risk pregnancy group with significant difference (P 0.05). The perinatal outcome was abnormal in only 3 cases (0.38) in the 80 normal pregnancy group. The perinatal outcome abnormality rate in the high-risk pregnancy group was significantly higher than that in the normal pregnancy group. The difference was statistically significant in 15 cases with fetal umbilical artery and uterine spiral artery S / D values higher than normal range in high risk pregnancy group, including 12 cases with perinatal adverse outcome. The incidence of adverse pregnancy outcome was significantly higher than that of fetal umbilical artery and uterine spiral artery S / D abnormality group, the difference was statistically significant (P 0.05). Conclusion: color Doppler ultrasound can be used to monitor the blood flow of fetal umbilical artery and uterine spiral artery in the third trimester of pregnancy, which has clinical value in predicting the outcome of pregnancy. The combined monitoring is more valuable than the single monitoring of fetal umbilical artery or uterine spiral artery in predicting the adverse outcome of the fetus in high-risk pregnancy. Monitoring the uterine spiral artery can be used as a supplement to the umbilical artery in predicting the adverse outcome of pregnancy.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R714.2;R445.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 鄭紀(jì)寧,李玉紅,高玉峰,張瑞祥;妊高征胎盤床螺旋動(dòng)脈的形態(tài)學(xué)改變[J];承德醫(yī)學(xué)院學(xué)報(bào);2001年02期

2 李毅萍;;160例高危妊娠孕產(chǎn)婦心理分析與對策[J];當(dāng)代護(hù)士(學(xué)術(shù)版);2006年08期

3 文黎明;;胎兒臍動(dòng)脈血流測定150例臨床分析[J];當(dāng)代醫(yī)學(xué);2009年15期

4 高雪松,肖小敏;聯(lián)合應(yīng)用無應(yīng)激試驗(yàn)、生物物理評分及臍動(dòng)脈血流速度監(jiān)測胎兒宮內(nèi)窘迫226例[J];廣東醫(yī)學(xué);2003年03期

5 陳衛(wèi)華;羅紅鳳;葉軍;謝曉英;韓文玲;豐靖卿;;胎兒大腦中動(dòng)脈及臍動(dòng)脈血流監(jiān)測對胎兒宮內(nèi)缺氧的診斷價(jià)值[J];贛南醫(yī)學(xué)院學(xué)報(bào);2007年06期

6 馬燕;崔淑麗;劉嵐;馬宏;;彩色多普勒超聲診斷胎兒主要?jiǎng)用}血流動(dòng)力學(xué)變化的臨床價(jià)值[J];臨床超聲醫(yī)學(xué)雜志;2006年07期

7 楊華,盧菊蘭,陳淑民;胎兒臍血流S/D值在臨床的應(yīng)用價(jià)值[J];寧夏醫(yī)學(xué)雜志;2000年08期

8 劉偉;林其德;夏建國;;正常孕婦和子癇前期患者子宮動(dòng)脈血流阻力的研究[J];上海交通大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2006年12期

9 張曉紅;雷繼剛;劉華;張彥峰;郭大慶;;彩色多普勒超聲檢測臍動(dòng)脈血流與胎兒宮內(nèi)窘迫的臨床分析[J];衛(wèi)生職業(yè)教育;2007年02期

10 滕想;李歌妹;李素霞;王民;馬文娜;婁志峰;;彩色多普勒血流動(dòng)力學(xué)指標(biāo)預(yù)測胎兒缺氧的價(jià)值[J];中國婦幼保健;2006年14期

，

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