胎心监护联合胎儿脐血流监测预测胎儿宫内窘迫的研究(1)
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[摘要] 目的 对胎心变化及胎儿脐血流进行监测，以期寻找一种准确、有效的早期诊断胎儿宫内窘迫的方法。方法 对98名足月妊娠妇女或需提前终止妊娠、孕周>36周的孕妇，分别行胎心率电子监护、彩超检查检测脐动脉血流变化，并应用统计学方法研究上述观察指标与胎儿宫内窘迫发生的关系。结果 98例入选产妇中临床确诊胎儿宫内窘迫16例。监测中二项检查均正常者共53例，出现假阴性4例，临床符合率为92.45%(49/53)；监测中一项检查异常者共24例，出现假阳性7例，临床符合率为70.83%(17/24)；二项检查异常者13例，假阳性1例，临床符合率为92.31%(12/13)，与一项检查异常(单项监测)的临床符合率进行χ2检验，差异有统计学意义(P<0.01)。结论 胎心监护联合胎儿脐血流监测预测胎儿宫内窘迫准确性高，可以祢补单一检查的不足，值得推广和应用。
[关键词] 胎心率电子监护；彩超；联合监测；胎儿宫内窘迫
[中图分类号] R714 [文献标识码] B [文章编号] 1673-9701(2011)34-47-02
Fetal Heart Rate Monitoring Combined Fetal Umbilical Blood Flow Monitoring and Forecasting Study of Fetal Distress
WU Shuling PENG Xiaolian CAI Mingli
Fujian Province Jinjiang City Hospital，Jinjiang 362200，China
[Abstract] Objective To monitor the fetal heart rate changes and fetal umbilical blood flow，and in order to find an accurate，early diagnosis and effective method of fetal distress. Methods All of 98 full-term pregnant women giving birth or because of medical indications require early termination of pregnancy，gestational age>36 weeks pregnant were treated by electronic fetal heart rate monitoring from June 2009 to May 2010 in our hospital，and by ultrasound examination detected umbilical artery blood flow， and applied statistical methods to study the observed indicators and the relationship between the occurrence of fetal distress. Results In 98 cases selected for maternal，clinical diagnosis of fetal distress was 16 patients. Monitoring the two tests normal in 53 cases，false negative in 4 cases，the clinical rate was 92.45%(49/53). An abnormal in 24 cases，false positive in 7 cases，the clinical rate was 70.83%(17/24). Two abnormalities in 13 cases，false positive in 1 case， the clinical rate was 92.31%(12/13)，with the single exception(single monitor) for the chi-square test，the difference was statistically significant(P<0.01). Conclusion The monitoring of individual monitoring is to exclude the interference of various factors，to determine the fetal safety of the state to improve the accuracy.
[Key words] Electronic fetal heart rate monitoring；Ultrasound；Joint monitoring；Fetal distress ......
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