彩色多普勒超声监测生长迟缓胎儿脐动脉血液循环的变化

摘要

目的　应用彩色多普勒超声监测生长迟缓（IUGR）胎儿的脐动脉血液循环。方法　测定130例妊娠20～42周妇女(其中正常49例、IUGR 81例)脐动脉时间平均血流速度（TAMX）、收缩期最大血流速度与舒张末期血流速度的比值（S／D）、搏动指数（PI）、阻力指数（RI）、收缩期最大血流速度(Vmax)与舒张末期血流速度（Vmin）。结果　正常孕妇随孕龄增长，胎盘功能增强，胎儿血液循环日渐丰富。IUGR者则明显障碍，在20周时脐动脉TAMX显著下降，在30周后S／D、 PI及RI显著升高，Vmin显著下降，在35周时Vmax显著下降。出现舒张期血流停止或倒流。结论　彩色多普勒超声可直接测定脐动脉血液循环，能在早期诊断IUGR、判断病情及估计预后。%Objective　To study the changes of the fetal circulation in intrauterine growth retardation (IUGR) cases.Methods　Color Doppler ultrasound was used to detect blood flow velocity waveforms of the umbilical artery (UmA)in 130 pregnant women at 20～42 weeks′ gestation,of which 49 cases were normal pregnancy and 81 cases were IUGR.The indices included time average maximum (TAMX) ,pulsatility index (PI) , resistance index (RI) ,systolic maximum velocity (Vmax) /diastolic minimum velocity (Vmin) ratio (S/D).Results　The results showed that the fetal circulation became abundant gradually with increasing gestational age in normal pregnancy group,but that TAMX was markedly decreased at 20 weeks′ gestation,S/D ratio,PI and RI were markedly elevated,Vmin was markedly decreased at 30 weeks′ gestation,and Vmax was markedly decreased at 35 weeks′ gestation in IUGR group.Conclusions　Examining blood flow velocity waveforms of UmA by Color Doppler ultrasound was one of the best method to early diagnose and predict the prognosis of IUGR.