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目的探讨彩色多普勒血流显像(CDFI)联合检测胎儿肾动脉(RA)及大脑中动脉(MCA)血流动力学改变,对产前胎儿宫内窘迫的预测价值。方法应用CDFI监测50例中晚期正常妊娠及55例胎儿宫内窘迫组MCA,RA收缩期最大血流速度(S)与舒张末期血流速度(D)的比值(S/D)、搏动指数(PI)及阻力指数(RI)并与妊娠结局相对照。结果正常妊娠组随孕周增加MCA和RA的S/D及PI、RI值逐渐下降;胎儿宫内窘迫组胎儿RA血流S/D、PI、RI值随妊娠周数增加呈上升趋势,MCA血流S/D、PI、RI值妊娠周数的增加,呈逐渐下降的倾向。产前胎儿MCA血流S/D<4、PI<1.6、RI<0.6时,RA血流S/D>4、PI>1.8、RI>0.8时,可提示胎儿宫内窘迫。结论胎儿宫内窘迫是导致胎儿窘迫、围产儿死亡的主要原因,联合检测脑肾动脉血流动力学改变对预测胎儿宫内窘迫及不良结局有重要提示意义。
Objective To investigate the predictive value of prenatal fetal distress using color Doppler flow imaging (CDFI) combined with hemodynamic changes in fetal renal artery (RA) and middle cerebral artery (MCA). Methods CDFI was used to detect the ratio of S / D, S / D, Pulsatile index (P <0.05) of MCA in systolic blood pressure and systolic blood pressure in 50 cases of normal pregnancy and 55 cases of fetal distress. PI) and resistance index (RI) and compared with the pregnancy outcome. Results The S / D, PI and RI of MCA and RA gradually decreased with the increase of gestational age in normal pregnancy group. The S / D, PI and RI of RA blood flow in fetus with fetal distress increased with the increase of gestational weeks, and MCA Blood flow S / D, PI, RI values increased the number of gestational weeks, showing a gradual decline tendency. Prenatal fetal MCA blood flow S / D <4, PI <1.6, RI <0.6, RA blood flow S / D> 4, PI> 1.8, RI> 0.8 can prompt fetal distress. Conclusion Fetal distress is the main cause of fetal distress and perinatal death. The combined detection of hemodynamic changes of brain and renal artery is of great significance in predicting fetal distress and adverse outcomes.