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目的:分析探讨胎儿脐动脉收缩期峰值和舒张末期流速之比值(S/D值)在诊断胎儿宫内窘迫中的预测价值。方法:选取自2011年3月至2013年11月于舟山市妇幼保健院分娩的孕妇420例,分为宫内窘迫组62例,正常组358例。采用多普勒彩超仪检测胎儿的S/D值,对两组胎儿各产程的S/D值进行比较,并对S/D值的预测价值行ROC分析。结果:宫内窘迫组胎儿临产前的S/D值与正常组的差异无统计学意义(P>0.05),但潜伏期、活跃期和第二产程的S/D值明显高于正常组胎儿,差异具有统计学意义(P<0.05)。ROC曲线诊断S/D值的cut-off值为2.77时,AUC为0.939(95%CI为0.895~0.983),其诊断效能最大。结论:胎儿脐血流S/D值能有效诊断胎儿宫内窘迫,具有非常高的预测价值,值得在临床上推广应用。
Objective: To investigate the predictive value of the ratio of peak systolic and end-diastolic flow velocity (S / D) in fetal umbilical artery in the diagnosis of fetal distress. Methods: From March 2011 to November 2013, 420 pregnant women delivered at Zhoushan MCH were divided into 62 cases of intrauterine distress group and 358 cases of normal group. The S / D value of fetus was detected by Doppler color doppler, and the S / D values of the two groups of fetuses were compared, and ROC analysis was performed on the predictive value of S / D value. Results: There was no significant difference in pre-labor S / D values between fetuses with intrauterine distress (P> 0.05), but the S / D values in latency, active period and second stage of labor were significantly higher than those in normal fetuses, The difference was statistically significant (P <0.05). When the cut-off value of ROC curve diagnosis S / D value was 2.77, the AUC was 0.939 (95% CI 0.895-0.983), which had the highest diagnostic efficiency. Conclusion: Fetal umbilical cord blood flow S / D value can effectively diagnose fetal distress, which has a very high predictive value and is worth popularizing in clinic.