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目的探讨胎心监护无负荷试验(NST)中变化减速(VD)发生的影响因素及围生儿结局。方法回顾性分析山东省立医院2001年2月至2005年2月5120例NST中出现VD的283例监护图形,比较不同图形影响因素的发生率和围生儿结局。结果NST中VD的发生率5.53%(283/5120)。单纯VD中影响因素发生率56.49%(87/154),不典型VD中影响因素发生率94.57%(122/129),差异具有显著性意义(χ2=52.7,P<0.01)。在分娩的283例新生儿中,1分钟Apgar评分>7分者252例,≤7分者31例,其中单纯VD组新生儿窒息率2.59%(4/154),而不典型VD组新生儿窒息率20.92%(27/129),差异具有显著性意义(χ2=24.2,P<0.01);单纯VD组剖宫产率(21.43%,33/154)低于不典型VD组(55.04%,71/129),差异具有显著性意义(χ2=34.1,P<0.01)。结论NST中变化减速的发生与多种因素有关,脐带异常最常见,不典型VD较典型者影响因素更明确,新生儿窒息的发生率更高,不典型VD较单纯VD更容易发生胎儿宫内窘迫。
Objective To investigate the influencing factors of change and deceleration (VD) in fetal heart rate monitoring non-load test (NST) and perinatal outcome. Methods A retrospective analysis of Shandong Provincial Hospital from February 2001 to February 2005 5,120 cases of NVD in the emergence of 283 cases of monitoring graphics to compare the incidence of different graphics factors and perinatal outcomes. Results The incidence of VD in NST was 5.53% (283/5120). The incidence rate of influential factors in VD was 56.49% (87/154), in atypical VD was 94.57% (122/129), the difference was significant (χ2 = 52.7, P <0.01). Of the 283 newborn babies who delivered at one minute, 252 cases had Apgar score> 7 points and 31 cases had ≤7 points, in which neonatal asphyxia rate was 2.59% (4/154) in VD group, while neonatal asphyxia in atypical VD group The asphyxia rate was 20.92% (27/129), the difference was significant (χ2 = 24.2, P <0.01). The cesarean section rate in VD group was significantly lower than that in atypical VD group (21.43%, 33/154) 71/129), the difference was significant (χ2 = 34.1, P <0.01). Conclusion The occurrence of NST degeneration is related to many factors. Umbilical cord anomalies are most common. Atypical VD is more specific than typical factors and the incidence of neonatal asphyxia is higher. Atypical VD is more likely to occur in fetal intrauterine Distress.