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目的:探讨子痫前期(PE)胎儿静脉导管(DV)、脐静脉(UV)和脐动脉(UA)及大脑中动脉(MCA)血流检测对围生儿预后分析。方法:应用彩色多普勒超声检测PE胎儿的DV、UV和UA及MCA血流参数,并与相应孕周正常妊娠胎儿的血流测值进行对照分析,研究分析其与胎儿不良结局的关系。结果:28~31+6周及36周~分娩前,重度PE胎儿的DV、UV血流测值较正常、轻度PE胎儿升高(P<0.05),轻度PE与正常胎儿比较差异无统计学意义(P>0.05)。32周~35+6周,PE胎儿的DV血流参数测值PLI、PVIV、PIV及Qdv/Quv随着PE严重程度呈上升趋势(P<0.05)。28周~分娩前,重度PE胎儿UA血流测值较正常、轻度PE胎儿升高(P<0.05),轻度PE胎儿UA血流测值RI、PI、S/D与正常胎儿比较差异无统计学意义(P>0.05),28~36周PE胎儿的MCA血流测值RI、PI、S/D与正常胎儿比较差异有统计学意义(P<0.05)。PE胎儿DV、UV、UA血流测值与新生儿的出生体重、Apgar评分、脐动脉血氧饱和度、脐静脉p H值呈负相关。PE胎儿DV的PVIV、PIV,UV的Qdv/Quv,UA的PI、S/D和MCA的RI值与新生儿出生结局相关(P<0.05)。结论:DV、UV血流频谱变化可反映PE胎儿宫内状况及预测出生不良结局,若结合UA、MCA血流频谱进行联合分析,将能更准确地评估胎儿的宫内状况。
Objective: To investigate the prognosis of perinatal infants in preeclamptic (PE) fetal blood flow detection of fetal venous catheter (DV), umbilical vein (UUVA) and middle cerebral artery (MCA) Methods: The blood flow parameters of DV, UV, UA and MCA in PE fetus were detected by color Doppler ultrasonography. The blood flow parameters were compared with those of fetus with normal gestational age. The relationship between fetal and fetal adverse outcomes was analyzed. Results: The DV and UV blood flow of pre-delivery and severe PE fetuses were significantly higher than those of normal and mild PE fetuses at 28-31 + 6 weeks and 36 weeks (P <0.05). There was no difference between mild PE and normal fetuses Statistical significance (P> 0.05). From 32 weeks to 35 + 6 weeks, the parameters of DV flow in PE fetus PLI, PVIV, PIV and Qdv / Quv increased with the severity of PE (P <0.05). Before 28th week, the blood flow of UA in severe PE fetus was higher than that in normal and mild PE fetuses (P <0.05). The RI, PI, S / D of UA in mild PE fetuses were significantly lower than those in normal fetuses There was no significant difference between the two groups (P> 0.05). The RI, PI, S / D of fetus with PE fetuses at 28-36 weeks were significantly different from those of normal fetuses (P <0.05). PE fetal DV, UV, UA blood flow measurements and newborn birth weight, Apgar score, umbilical arterial oxygen saturation, umbilical vein p H value was negatively correlated. The RI values of PVIV, PIV, UV Qdv / Quv, UA PI, S / D and MCA in PE fetuses were correlated with the neonatal outcome (P <0.05). Conclusion: The change of DV and UV blood flow can reflect the status of fetal intrauterine growth and predict the unfavorable outcome. If combined with UA and MCA flow spectrum, the intrauterine status of fetus will be evaluated more accurately.