论文部分内容阅读
目的应用胎儿超声心动图观察20～34周正常胎儿的肺动脉及其左右分支,通过测量其肺动脉主干及其分支的内径、血流动力学参数,了解各项指标的变化规律;并观察肺动脉左右分支有无差别。方法入选妊娠20～34周的正常胎儿560例,分别观察胎儿的肺动脉主干内径、血流峰速、频谱持续时间;肺动脉左右分支内径、频谱形态、血流峰速及频谱持续时间。以胎龄2周为一阶段分组,共分为:20～22周、22+～24周、24+～26周、26+～28周、28+～30周、30+～32周、32+～34周7组,用SPSS13.0统计学软件进行统计分析。结果肺动脉主干内径随孕周的增大而增大,两者存在线性相关,相关系数r=0.68,一元一次线性回归方程为Y=0.286X-2.510,血流频谱呈单峰,峰值流速随孕周的增加而增快,频谱持续时间不随胎龄的改变而改变;肺动脉分支内径随孕周的增大而增大,与孕周均存在线性相关,右肺动脉与孕周的相关系数r=0.60,一元一次线性回归方程为Y=0.156X-1.304,左肺动脉与孕周的相关系数r=0.65,一元一次线性回归方程为Y=0.148X-1.240,血流频谱均呈单向双峰,第一峰值高,持续时间短,第二峰值低,持续时间长,第一峰的峰值流速与肺动脉主干的峰值流速接近,并随孕周的增大而增快,第二峰的峰值流速不随孕周的改变而改变,两个峰持续的时间之和小于肺动脉主干频谱的持续时间,分支的频谱形态及持续时间不随孕周改变而改变;主肺动脉内径大于左右分支的内径,右侧分支内径大于左侧分支内径,左右分支的频谱形态、峰值及持续时间无明显差异。结论正常胎儿肺动脉主干及左右分支的内径受到孕周的影响,随孕周的增大而增大;肺动脉主干的峰值流速与左右分支的前峰峰值流速接近,随孕周的增加而增快;肺动脉左右分支的频谱呈单向双峰,形成较早,形态固定。胎儿超声心动图能够动态观察胎儿肺动脉的解剖特征,并能对其内径、血流频谱等进行测量,是观察胎儿肺循环的一种有效、可靠的检查方法。
Objective To observe the pulmonary artery and its left and right branches of normal fetuses from 20 to 34 weeks by fetal echocardiography and to study the changes of the indexes of the pulmonary arteries by measuring the diameter and hemodynamic parameters of the main pulmonary artery and its branches. Is there any difference? Methods 560 fetuses with normal fetuses from 20 to 34 weeks of gestation were selected to observe the diameter, peak velocity and duration of the pulmonary arteries in the fetus. The left and right branches of the pulmonary artery, the diameter of the pulmonary artery, the shape of the blood flow and the duration of the spectrum were observed. Divided into two groups of gestational age of 2 weeks: 20 to 22 weeks, 22 to 24 weeks, 24 to 26 weeks, 26 to 28 weeks, 28 to 30 weeks, 30 to 32 weeks, 32 + ~ 34 weeks 7 groups, using SPSS13.0 statistical software for statistical analysis. Results The diameter of the main pulmonary artery increased with the increase of gestational age. The correlation coefficient was 0.68. The linear regression equation was Y = 0.286X-2.510. The blood flow spectrum showed a single peak. The peak flow rate increased with gestational age Week, the duration of the spectrum did not change with the change of gestational age. The diameter of pulmonary artery branch increased with the increase of gestational age, which was linearly correlated with gestational age. The correlation coefficient between right pulmonary artery and gestational age was 0.60 , The linear regression equation was Y = 0.156X-1.304, the correlation coefficient between left pulmonary artery and gestational age was 0.65, the linear regression equation was Y = 0.148X-1.240, the blood flow spectrum showed a unidirectional bimodal, the first A peak high, short duration, the second peak is low, long duration, the peak velocity of the first peak and pulmonary artery peak velocity close, and with the gestational age increased faster peak velocity of the second peak does not with the pregnancy The change of the week changes, the sum of the two peak duration is less than the duration of the main pulmonary artery spectrum, the branch of the spectral shape and duration does not change with gestational age to change; main pulmonary artery diameter greater than the left and right branches of the inner diameter of the right branch diameter greater than Left branch diameter, left and right points The spectral shape, peak and duration of branch had no significant difference. Conclusion The diameter of the main pulmonary artery and the left and right branches of normal fetuses are affected by gestational age and increase with the increase of gestational age. The peak flow velocity of the pulmonary artery is close to the peak flow velocity of the left and right branches, and increases with the increase of gestational weeks. The spectrum of the left and right pulmonary branches showed a unidirectional bimodal pattern, forming earlier and with a fixed shape. Fetal echocardiography can dynamically observe the anatomy of the fetal pulmonary artery, and its inner diameter, blood flow spectrum, etc., is to observe the fetal pulmonary circulation is an effective and reliable method of inspection.