摘要
目的 分析胎儿大脑中动脉、脐动脉血流指标水平与脐血血气分析结果的相关性。方法 选取90例孕产妇,根据是否出现胎儿窘迫分为对照组(未发生胎儿窘迫,74例)和观察组(发生胎儿窘迫,16例)。于孕产妇孕晚期实施常规超声检查,并在新生儿出生后进行脐血血气分析检测。比较两组胎儿大脑中动脉及脐动脉血流指标[舒张期血流速度(VD)、收缩期血流速度(VS)、搏动指数(PI)、阻力指数(RI)及收缩期峰值血流速度与舒张末期血流速度之比(S/D)]水平,胎儿脐血血气指标[二氧化碳分压(PCO_(2))、氧分压(PO_(2))、碱剩余(BE)、p H值]水平;分析胎儿大脑中动脉及脐动脉血流指标水平与脐血血气指标水平相关性。结果 对照组大脑中动脉VD、VS、PI、RI及S/D分别为(20.17±2.01)cm/s、(68.31±2.39)cm/s、(1.48±0.28)、(0.74±0.18)、(4.45±0.74),脐动脉VD、VS、PI、RI及S/D分别为(16.64±4.25)cm/s、(61.02±4.21)cm/s、(0.74±0.21)、(0.59±0.10)、(3.24±0.72);观察组大脑中动脉VD、VS、PI、RI及S/D分别为(15.04±2.03)cm/s、(66.25±2.37)cm/s、(1.25±0.31)、(0.55±0.14)、(3.22±0.85),脐动脉VD、VS、PI、RI及S/D分别为(12.25±3.89)cm/s、(57.26±4.30)cm/s、(1.02±0.20)、(0.75±0.14)、(2.25±0.64)。与对照组相比,观察组胎儿大脑中动脉VD、VS、PI、RI及S/D更低,脐动脉VD、VS、S/D更低,脐动脉PI、RI更高(P<0.05)。观察组胎儿p H(7.15±0.03)、PO_(2)(23.24±4.29)mm Hg(1 mm Hg=0.133 k Pa)及BE(-7.24±1.41)mmol/L低于对照组的(7.26±0.02)、(28.11±4.36)mm Hg、(-6.01±1.45)mmol/L,PCO_(2)(61.33±2.37)mm Hg高于对照组的(45.35±2.31)mm Hg(P<0.05)。胎儿大脑中动脉VD、VS、PI、RI、SD与脐血p H、PO_(2)、BE呈正相关,与脐血PCO_(2)呈负相关(P<0.05)。胎儿脐动脉VD、VS、SD与p H、PO_(2)、BE呈正相关,与PCO_(2)呈负相关(P<0.05),脐动脉血PI、RI与p H、PO_(2)、BE呈负相关,与PCO_(2)呈正相关(P<0.05)。结论 胎儿大脑中动脉、脐动脉血流指标水平与脐血血气分析结果存在相关性,明确动脉血流指标水平以及脐血血气分析结果可为临床评估胎儿窘迫提供指导。
Objective To analyze the correlation of the blood flow indexes of fetal middle cerebral artery and umbilical artery with the results of umbilical cord blood gas analysis.Methods 90 pregnant women were selected and divided into a control group(no fetal distress,74 cases)and an observation group(fetal distress,16 cases)according to whether there was fetal distress.Routine ultrasound examination was performed in the third trimester of pregnancy and umbilical cord blood gas analysis was performed after birth.Comparison was made on blood flow indexes[diastolic velocity(VD),systolic velocity(VS),pulsation index(PI),resistance index(RI)and the ratio of peak systolic velocity to end-diastolic velocity(S/D)]of fetal middle cerebral artery and umbilical artery were compared between the two groups,as well as the blood gas index[partial pressure of carbon dioxide(PCO_(2)),partial pressure of oxygen(PO_(2)),base excess(BE),pH value]of fetal cord blood.The correlation of the blood flow indexes of fetal middle cerebral artery and umbilical artery with the results of umbilical cord blood gas analysis was analyzed.Results In the control group,the values of VD,VS,PI,RI and S/D of middle cerebral artery were(20.17±2.01)cm/s,(68.31±2.39)cm/s,(1.48±0.28),(0.74±0.18)and(4.45±0.74),and those of umbilical artery were(16.64±4.25)cm/s,(61.02±4.21)cm/s,(0.74±0.21),(0.59±0.10)and(3.24±0.72).In the observation group,the values of VD,VS,PI,RI and S/D of middle cerebral artery were(15.04±2.03)cm/s,(66.25±2.37)cm/s,(1.25±0.31),(0.55±0.14)and(3.22±0.85),and those of umbilical artery were(12.25±3.89)cm/s,(57.26±4.30)cm/s,(1.02±0.20),(0.75±0.14)and(2.25±0.64).Compared with the control group,the values of VD,VS,PI,RI and S/D of fetal middle cerebral artery in the observation group were lower;VD,VS and SD of umbilical artery were lower,while the values of PI and RI were higher(P<0.05).The observation group had fetal pH of(7.15±0.03),PO_(2) of(23.24±4.29)mm Hg(1 mm Hg=0.133 kPa)and BE of(-7.24±1.41)mmol/L,which were lower than(7.26±0.02)and(28.11±4.36)mm Hg and(-6.01±1.45)mmol/L in the control group;the observation group had higher PCO_(2) of(61.33±2.37)mm Hg than(45.35±2.31)mm Hg in the control group(P<0.05).The values of VD,VS,PI,RI and SD of fetal middle cerebral artery were positively correlated with pH,PO_(2) and BE of umbilical artery,and negatively correlated with PCO_(2) of umbilical artery(P<0.05).The value of VD,VS and SD of fetal umbilical artery were positively correlated with pH,PO_(2) and BE,and negatively correlated with PCO_(2)(P<0.05).The value of PI and RI of umbilical artery were negatively correlated with pH,PO_(2) and BE,and positively correlated with PCO_(2)(P<0.05).Fetal middle cerebral artery blood flow index was positively correlated with umbilical cord blood pH,PO_(2),BE,and negatively correlated with PCO_(2)(P<0.05).Fetal umbilical artery blood flow indexes VD,VS and SD were positively correlated with pH,PO_(2) and BE,and negatively correlated with PCO_(2)(P<0.05).Umbilical artery blood flow indexes PI and RI were negatively correlated with pH,PO_(2) and BE,and positively correlated with PCO_(2)(P<0.05).Conclusion There is a correlation between the blood flow indexes of fetal middle cerebral artery and umbilical artery and the results of umbilical cord blood gas analysis.Clarifying the blood flow indexes of fetal arteries and the results of mbilical cord blood gas analysis can provide guidance for clinical evaluation of fetal distress.
作者
张莉
林玲
罗怀英
饶福光
ZHANG Li;LIN Ling;LUO Huai-ying(Department of Neonatology,Longgang District Maternal and Child Health Hospital(Longgang Maternal and Child Clinical College of Shantou University Medical College),Shenzhen 518100,China)
出处
《中国实用医药》
2024年第6期81-84,共4页
China Practical Medicine
关键词
大脑中动脉
脐动脉
血流指标
脐血血气分析
胎儿窘迫
Middle cerebral artery
Umbilical artery
Blood flow indexes
Umbilical cord blood gas analysis
Fetal distress
