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目的建立中晚孕期正常胎儿静脉导管和脐静脉血流量参考范围,计算脐血流入静脉导管的百分比。方法应用彩色多普勒超声检查138例16~41孕周正常单胎胎儿,记录静脉导管和脐静脉血流波形,测定最大血流速度计算血流量。结果静脉导管血流量随着孕龄增加而增加(P<0.01),对应于体质量则随着孕龄增加而减低(P<0.01)。脐静脉血流速、血管管径、血流量随孕龄增加而增加(P<0.05,P<0.01,P<0.01),对应于体质量脐静脉血流量随着孕龄增加而减低(P<0.01)。静脉导管与脐静脉血流量(Qdv/Quv)之比随着妊娠进展而减低(P<0.01)。平均43%脐血流入静脉导管。结论中晚孕期胎儿脐血流入静脉导管随着妊娠进展而减低,静脉导管在分流含氧高的血到脑和心肌起着次要作用。
Objective To establish the reference range of normal fetal venous catheter and umbilical vein blood flow in middle and late pregnancy and calculate the percentage of umbilical cord blood flowing into venous catheter. Methods 138 cases of normal singleton fetus from 16 to 41 gestational weeks were examined by color Doppler ultrasonography. The blood flow of venous catheter and umbilical vein was recorded and the maximum blood flow velocity was calculated. Results Venous catheter blood flow increased with gestational age (P <0.01), corresponding to the body weight decreased with increasing gestational age (P <0.01). Umbilical venous blood flow velocity, blood vessel diameter and blood flow increased with gestational age (P <0.05, P <0.01, P <0.01), corresponding to the body mass of umbilical vein blood flow decreased with increasing gestational age P <0.01). The ratio of intravenous catheter to umbilical venous blood flow (Qdv / Quv) decreased with the progress of pregnancy (P <0.01). An average of 43% of cord blood flows into the venous catheter. Conclusions Fetal umbilical cord inflow into the venous catheter in the second and third trimester of pregnancy is reduced as the pregnancy progresses. Intravenous catheters play a secondary role in shunting high oxygenated blood to the brain and myocardium.