本文選題：輕度子癇前期 + 重度子癇前期��； 參考：《山西醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的 聯(lián)合監(jiān)測(cè)子癇前期患者32周-34周胎兒大腦中動(dòng)脈(MCA)及臍動(dòng)脈（UA）的PI(搏動(dòng)指數(shù))、S/D（收縮期與舒張期血流速度比值）、RI（血流阻力指數(shù)）等血流動(dòng)力學(xué)變化規(guī)律，并通過(guò)測(cè)量胎兒BPD（雙頂徑）、FL（股骨長(zhǎng)）、AC（腹圍）、HC（頭圍）等數(shù)據(jù)估算體重，評(píng)估其在預(yù)測(cè)胎兒在宮內(nèi)生長(zhǎng)狀況的價(jià)值，結(jié)合胎兒的有關(guān)結(jié)構(gòu)生物學(xué)測(cè)量，以便臨床及時(shí)的進(jìn)行干預(yù)和治療。 研究方法 選取2013年3月－2013年12月，就診于山西醫(yī)科大學(xué)第一醫(yī)院婦產(chǎn)科門(mén)診的孕婦96人，，年齡25-32歲，平均年齡28歲，孕齡為32-34周，平均33周，其中正常孕婦32人，無(wú)糖尿病等其他合并癥孕婦，診斷輕度子癇前期32人，重度子癇前期32人，采用GE E8彩色多普勒超聲檢查儀,經(jīng)腹部超聲探頭頻率為3.5-5MHz。 監(jiān)測(cè)胎兒大腦中動(dòng)脈(MCA)和臍動(dòng)脈（UA）血流參數(shù)：收縮期與舒張期血流速度比值(S/D)、血流阻力指數(shù)(RI)、搏動(dòng)指數(shù)(PI），并測(cè)量胎兒BPD、FL、AC、HC估算體重。 結(jié)果 1、正常組胎兒體重及MCA平均水平：體重為2059.81kg±246.74kg，PI為1.56±0.23， RI為0.80±0.10，S/D為4.29±0.17；輕度子癇前期組胎兒體重及MCA的平均水平：體重為1915.20±217.88kg，PI為1.41±0.21，RI為0.76±0.01，S/D為4.09±0.21；重度子癇前期組胎兒體重及MCA的平均水平:體重為1600.36±261.06kg，PI為1.06±0.18，RI為0.55±0.08，S/D為2.24±0.16； 2、正常組、輕度子癇前期組和重度子癇前期組胎兒UA各指標(biāo)PI、RI、S/D差別均有統(tǒng)計(jì)學(xué)意義。PI、RI、S/D是正常組胎兒最低，重度子癇前期組胎兒最高。本組研究中妊高征組患者UA各指標(biāo)均高于正常妊娠組孕婦，且隨患者病情逐漸加重呈逐漸遞增趨勢(shì)，輕度子癇前期組患者S/D值明顯高于正常組，差異具有顯著性((P0.05)，重度子癇前期組患者PI、RI、S/D值均明顯高于正常組，差異極顯著((P0.01)。 3、MCA各指標(biāo)PI、RI、S/D與胎兒體重呈正相關(guān)；UA各指標(biāo)PI、RI、S/D與胎兒體重呈負(fù)相關(guān)。結(jié)論 1、利用彩色多普勒超聲，聯(lián)合胎兒臍動(dòng)脈、大腦中動(dòng)脈的PI值、RI值、S/D值較單測(cè)臍動(dòng)脈或腦中動(dòng)脈的血流參數(shù)在預(yù)測(cè)胎兒宮內(nèi)生長(zhǎng)狀況更為敏感。 2、子癇前期孕婦胎兒的大腦中動(dòng)脈的血流動(dòng)力學(xué)數(shù)RI值、RI值、S/D值與胎兒體重值呈負(fù)相關(guān)。 3、兩者結(jié)合起來(lái)可以對(duì)子癇前期患者的胎兒度進(jìn)行估重，為綜合地評(píng)估胎兒宮內(nèi)發(fā)育狀況提供臨床依據(jù)，以便臨床及時(shí)進(jìn)行干預(yù)和治療。
[Abstract]:Purpose

The changes of PI ( pulsation index ) , S / D ( systolic and diastolic blood velocity ratio ) , RI ( blood flow resistance index ) and other hemodynamic changes of fetal brain ( MCA ) and umbilical artery ( UA ) were monitored in the early stage of pre - eclampsia .

Research Methods

From March 2013 to December 2013 , 96 pregnant women , aged 25 - 32 years , with an average age of 28 years and a gestational age of 32 - 34 weeks , were diagnosed as 32 - 34 weeks , with an average age of 28 years , with a mean age of 32 - 34 weeks , an average of 33 weeks .

Blood flow parameters of fetal brain middle artery ( MCA ) and umbilical artery ( UA ) were monitored : systolic and diastolic velocity ratio ( S / D ) , flow resistance index ( RI ) , beat index ( PI ) , and measured weight of fetal bpd , fl , ac , hc .

Results

1 . Body weight and MCA average of normal group : body weight was 2059.81 kg 鹵 246.74kg , PI was 1 . 56 鹵 0.23 , RI was 0.80 鹵 0.10 , S / D was 4.29 鹵 0.17 ;
The mean weight of fetal body weight and MCA in the pre - eclampsia group was 1915.20 鹵 217.88kg , PI was 1.41 鹵 0.21 , RI was 0.76 鹵 0.01 , S / D was 4.09 鹵 0.21 ;
The average weight of fetal weight and MCA in the pre - eclampsia group : body weight was 160.36 鹵 268.06kg , PI was 1.06 鹵 0.18 , RI was 0.55 鹵 0.08 , S / D was 2.24 鹵 0.16 ;


There was significant difference in PI , RI and S / D between normal group , mild sub - eclampsia group and severe pre - eclampsia group . The indexes of PI , RI and S / D were higher than those in the normal group , and the S / D value of patients with PIH group was significantly higher than that in normal group ( P < 0.01 ) .

3 . The indexes PI , RI and S / D of MCA were positively correlated with fetal body weight ;
There was a negative correlation between PI , RI , S / D and fetal body weight in UA .

1 . Using color Doppler ultrasound , the PI value , RI value and S / D value of umbilical artery and middle cerebral artery were more sensitive than those of single umbilical artery or middle cerebral artery .

2 . RI value , RI value and S / D value of middle cerebral artery were negatively correlated with fetal body weight .

3 . Taken together , the fetal degree of the pre - eclampsia can be estimated to provide a clinical basis for the comprehensive evaluation of the intrauterine development of the fetus , so as to intervene and treat the fetus in a timely manner .

【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R714.244;R445.1

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