超声与多普勒评价脐动脉频谱与胎儿生长受限(FGR)的关系.doc

超声多普勒评价脐动脉频谱与胎儿 生长受限（FGR）的关系 摘要 目的?探讨脐动脉血流频谱异常与胎儿宫内生长受限的关系。 方法?妊娠28-42周孕妇200例，分为二组，正常对照组100例，胎儿各项生长参数都在正常范围；异常组100例，胎儿头围、双顶径、腹围、股骨长低于正常平均值的两个标准差；分别测量脐动脉收缩期峰值流速(MAX）和舒张期末流速（MIX)，判断脐动脉收缩期峰值流速(MAX）和舒张期末流速（MIX)的比值（S/D)。 结果?异常组胎儿S/D值大于等于3的例数明显多于正常对照组，胎儿生长受限的发生率也明显高于正常对照组（P＜0.05），差异具有统计学意义。 结论?脐动脉血流S/D值增大，与胎儿生长受限有一定的相关性，对晚孕期怀疑胎儿生长受限的孕妇进行脐动脉多普勒频谱的测定能较好的反映胎盘功能，为临床诊断FGR提供重要依据。 关键词 多普勒频谱 胎儿生长受限?胎盘功能 作者简介：承晓霞，女，安徽省芜湖县医院超声科 主治医师 本科学历 作者通讯：承晓霞 芜湖县医院超声科 电子邮箱1157342648@ Ultrasound?Doppler estimate?the?relationship?between?umbilical?artery?spectrum?and?fetal growth restriction Abstract：?Objective?：To approach a subject from the abnormal?phenomena of umbilical artery?Doppler?with fetal growth restriction . Methods?：In 200 cases of pregnant women?(gestation from twenty eight to forty two) are divided two parts. The first one hundred?cases,?the fetal growth parameter is?normal. The rest is lower two standard deviation average value from the head circumference HC, biparietal diameter BPD, abdominal circumference AC and femur length FL .We can measure Max and Mix. To judge the S/D from?systolic peak and diastolic?peak. Results?：The S/D is greater than or equal three of the second part?is more than the first parts.?In cases?of fetal growth restrictionincrease?the first parts obviously. P is less than 0.05 has statistical?significance. The abnormal?phenomena?of umbilical arteryspectral?Doppler?is?related?to fetal growth restriction. Conclusions：The?increasing?of umbilical artery S/D is related to fetal growth restriction in Doppler determination of distrusting fetal growth restriction in pregnant later stage. This conclusion is?also supported for clinics in anticipating FGR. Key words:?Spectral?Doppler; Fetal growth restriction; Placenta function ? ???在胎儿生长发育过程中，任何阶段的内外因素的干扰、障碍都会出现各种发育异常、功能障碍，导致各种先天畸形、异常甚至流产或胎死宫内。随着三维超声技术的发展，系统产前检查的普及，很多胎儿畸形都能在中孕及晚孕早期得到确诊[1]，但是对胎盘功能障碍导致的胎儿生长受限往往缺少明确的诊断依据，超声多普勒检测胎儿脐动脉血流状态，具有无创、方便、安全的特点，通过对脐动脉血流的检测，尤其是收缩期峰值流速(MAX）和舒张期末流速（MIX)的比值（S/D)，可以了解胎儿胎盘循环功能，为临床评价胎儿宫内