妊娠晚期不同孕周脐动脉血流S 异常值标准分析

　　【关键词】脐动脉血流图;异常值

　　Investigate the S/D unusual boundary value in navel artery blood flow picture

　　ZHANG ZaiqingLI Fasheng

　　The Second People s Hospital of Shenzhen518035

　　【Abstract】ObjectiveTo investigate the S/D unusual boundary value in navel artery blood flow picture.Methods1752 cases of the navel arteries blood flow in later period gestation were detected by fetus navel blood flow detector.The average value and standard deviation of S/D of every pregnant weeks were calculated and the unusually demarcation line value were analysed.S/D≥3.0 was regarded as the unusual worth of the 36th pregnant week.This value increased by 0.1 with the pregnant weeks decreasing every one week and thus the opposite.ResultsThe unusual checked-out rate 6.8% was stable.ConclusionIt was more helpful for clinical work with S/D unusual worth than S/D≥3.0 simple or with their average or standard deviation as unusual value.

　　【Key words】navel artery blood picture,unusual value

　　利用超声多普勒技术对胎儿胎盘进行血流监测，有利于早期发现胎儿宫内缺氧，及时予以正确处理，有利于保障围生儿的安全。脐血流收缩末期峰值(S)与舒张末期峰值(D)的比值，是临床最常用的指标，由于随妊娠周数的增加，胎盘循环阻力逐渐降低，舒张末期血流速度增加，S/D比值逐渐下降。由于S/D异常比值并不具有特定性，确定S/D值的异常值具有重要的临床价值。

　　1资料与方法

　　1.1一般资料2001年6月至2004年3月，选择我院门诊妊娠28周以上进行脐动脉血流监测的单胎妊娠1 752例进行分析，年龄19～39岁，平均28.5岁。其中，妊娠28周164例(9.4%)、妊娠29周168例(9.6%)、妊娠30周168例(9.6%)、妊娠31周168例(9.6%)、妊娠32周168例(9.6%)、妊娠33周100例(5.7%)、妊娠34周113例(6.4%)、妊娠35周104例(5.9%)、妊娠36周168例(9.6%)、妊娠37周168例(9.6%)、妊娠38周168例(9.6%)、妊娠39周63例(3.6%)、妊娠40周以上32例(1.8%)。

　　1.2方法应用仪器为广州三瑞医疗有限公司生产的SRF608型胎儿脐血流检测仪，探头5 MHz。检查方法：孕妇平卧检查台上，休息5　min，将探头置于胎儿腹部探寻脐动脉，当闻及典型的脐动脉血流音并于荧光屏上出现典型的脐动脉血流波形时，冻结波形并进行分析，测量5～15个波形，通过内储软件求得各个指标的平均值，分别算出S/D比值、PI(S-D/S)、RI(S-D/平均血流速度)、FVR(快速血流量比)及胎心率。

　　1.3判断标准以各妊娠周数S/D的平均值(x)、

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