孕期子宮動脈血流多普勒超聲監(jiān)測在高危妊娠中的應用

張麗梅

[摘要] 目的 探究孕期子宮動脈血流多普勒超聲監(jiān)測在高危妊娠中的臨床價值。 方法 便利選取該院于2016年7月—2018年10月收治的58例高危妊娠患者為試驗組，同期58名正常孕婦患者列為對照組，均給予孕早、中、晚多次子宮動脈多普勒超聲監(jiān)測。對比兩組患者超聲監(jiān)測參數(shù)值、觀察記錄兩組患者舒張末早期切跡發(fā)生情況與所有患者S/D比值正常、異常比例;比較試驗組早、中、晚子宮動脈多普勒超聲監(jiān)測值對高危妊娠有無預測價值。 結果 試驗組子宮動脈血流S/D比值、RI、PI參數(shù)值均高于對照組，差異有統(tǒng)計學意義（P<0.05），試驗組舒張末早期切跡發(fā)生為46.5%，對照組舒張末早期切跡發(fā)生為6.9%，差異有統(tǒng)計學意義（χ2=23.288，P<0.05）。所有患者中，S/D比值正常比例值為67.2%，S/D比值異常比例值為32.8%。試驗組有舒張早期切跡母嬰不良結局高于試驗組無舒張早期切跡，差異有統(tǒng)計學意義（P<0.05），S/D正常值患者母嬰不良結局低于 S/D比值異常患者，差異有統(tǒng)計學意義（P<0.05），試驗組有舒張期早期切跡的新生兒體重低于無舒張期早期切跡患者，差異有統(tǒng)計學意義（P<0.05），S/D比值正常患者新生兒體重高于S/D比值異常患者，差異有統(tǒng)計學意義（P<0.05）。結論 孕早、中、晚多次對子宮動脈多普勒超聲監(jiān)測的各項參數(shù)變化對高危妊娠有明顯的預測價值，其中 S /D 比值及舒張早期切跡在高危妊娠中有重要的臨床意義。

[關鍵詞] 孕期子宮動脈血流;多普勒超聲監(jiān)測;高危妊娠;舒張末早期切跡

[中圖分類號] R714? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1674-0742（2020）10（c）-0189-03

[Abstract] Objective To explore the clinical value of Doppler ultrasound monitoring of uterine artery blood flow during pregnancy in high-risk pregnancy. Methods A total of 58 high-risk pregnancy patients admitted to the hospital from July 2016 to October 2018 were selected， and 58 normal pregnant women were included in the study during the same period. They were all given multiple uterine artery Doppler ultrasound monitoring in the early， middle and late pregnancy. Compare the ultrasonic monitoring parameter values of the two groups of patients， observe and record the occurrence of early end-diastolic notches in the two groups and the normal and abnormal ratios of S/D in all patients; compare the early， mid and late uterine artery Doppler ultrasound monitoring values in the test group Whether there is predictive value for high-risk pregnancy. Results The uterine artery blood flow S/D ratio， RI and PI parameter values of the experimental group were higher than those of the control group，the difference was statistically significant（P<0.05）. The occurrence of early end-diastolic notches in the experimental group was 46.5%， and the occurrence of early end-diastolic notches in the control group was 6.9%， the difference was statistically significant（χ2=23.288， P<0.05）. In all patients， the normal S/D ratio was 67.2%， and the abnormal S/D ratio was 32.8%. The adverse maternal and infant outcome of the test group with early diastolic notch was higher than that of the test group without early diastolic notch，the difference was statistically significant（P<0.05）. The adverse maternal and infant outcome of patients with normal S/D was lower than those with abnormal S/D ratio，the difference was statistically significant（P<0.05）. The weight of newborns with early diastolic notch in the experimental group was lower than that of patients without early diastolic notch，the difference was statistically significant（P<0.05）， and the weight of newborns with normal S/D ratio was higher than that of patients with abnormal S/D ratio，the difference was statistically significant（P<0.05）. Conclusion The changes in various parameters of uterine artery Doppler ultrasound monitoring in the early， middle and late pregnancy have obvious predictive value for high-risk pregnancy. Among them， S/D ratio and early diastolic notch have important clinical significance in high-risk pregnancy.