产前胎心监护异常及胎儿宫内窘迫相关性探究.doc

产前胎心监护异常及胎儿宫内窘迫相关性探究[摘要] 目的：探讨产前、产时胎心监护异常曲线与胎儿宫内窘迫的相关性。方法：对产前、产时使用胎儿电子监护仪的1 252例经腹壁对胎心率和宫缩进行监测的孕妇进行回顾性分析。结果：1 252例孕妇中，胎心监护异常曲线者115例，占9.19%（115/1 252）。115例中产后发现异常因素90例，占78.26%（90/115）。新生儿窒息23例及新生儿死亡1例，占20.87%（24/115）。结论：产前胎心异常曲线对胎儿宫内窘迫的诊断具有重要价值。 [关键词] 产前胎心监护；胎儿宫内窘迫；相关性分析 [中图分类号] R714 [文献标识码]A [文章编号]1673-7210（2008）06（b）-037-02 To study the relationship between abnormal fetal heart rate curve and fetal distress before birth LI Ying1,LI Li2,SUN Wei-feng3* (1.Women and Children Health Care Hospital of Haizhu District,Guangzhou510240,China；2.Guangzhou General Hospital of Guangzhou Military Area Command of Chinese PLA，the 2005 Grade Graduate Student of Guangzhou TCM,Guangzhou 510010,China；3.Department of Traditional Chinese Mediane Guangzhou General Hospital of Guangzhou Military Area Command of Chinese PLA,Guangzhou 510010,China) [Abstract] Objective:To study the correlation between abnormal antepartum （including the first stage and the first stage）fetal heart rate curve and fetal distress in uterus.Methods: Retrospectively ananlyzed 1 252 laterpregnant women,their fetal heart rate and uterine contraction were monitored by fetal electronic monitoring instrument.Results:In 1 252 cases antepartum women,115 cases(9.19%) had abnormal fetal heart rate curve.In 115 cases,there were abnormal factors in 90 cases (78.26%); 23 cases new born distress and 1 case death (20.87%).Conclusion: Abnormal fetal heart rate curve has important value in diagnosis of fetal distress. [Key words] Antepartum fetal heart monitoring;Fetal distress;Correlation analysis 胎儿宫内窘迫是产科临床常见急症，若监测、处理不及时常导致新生儿窒息，围生儿死亡，给家庭及社会造成巨大的损失；若诊断及时，处理恰当，新生儿预后良好。20余年来，随着胎心电子监护仪广泛应用于产科临床，通过监护仪描述曲线记录了胎心基线率、基线率变异性和周期性胎心率等的变化，作为预测或判断胎儿宫内状况的依据，对胎儿宫内窘迫的预见性较高。为此，我们总结了产时胎心监护异常曲线与胎儿宫内窘迫及围生儿的相关性，对其进行分析。 1资料与方法 1.1 一般资料 回顾2003年1月～2006年7月在海珠区妇幼保健院及广州军区广州总医院住院的，足月、单胎、头位、临产的1 252例孕妇进行胎心监护，其孕周为36～41周。 1.2 方法 孕妇在无饥饿状态下，排空膀胱后取左侧卧位， 使用美国惠普胎儿监护仪，经腹壁对胎心率和宫缩进行监测。将超声多普勒探头置于胎心音最清楚的部位，宫缩探头置于宫底下二横指处，各自用腹带固定于