中华妇产科杂志
中華婦產科雜誌
중화부산과잡지
CHINESE JOUNAL OF OBSTETRICS AND GYNECOLOGY
2009年
3期
179-182
,共4页
马小卿%吴青青%李萍%王琪%李蔓
馬小卿%吳青青%李萍%王琪%李蔓
마소경%오청청%리평%왕기%리만
妊娠%先兆子痫%胎盘%局部血流%超声检查%多普勒%彩色
妊娠%先兆子癇%胎盤%跼部血流%超聲檢查%多普勒%綵色
임신%선조자간%태반%국부혈류%초성검사%다보륵%채색
Pregnancy%Pre-eclampsia%Placenta%Regional blood flow%U]trasonography,doppler,color
目的 探讨三维能量彩色多普勒超声检测子痫前期孕妇胎盘组织血流灌注的临床价值.方法 选择2007年7月至2008年5月在首都医科大学附属北京妇产医院超声科行产前超声检查的正常孕妇及子痫前期孕妇共80例,其中36例正常孕妇为正常孕妇组,44例子痫前期孕妇分为轻度子痫前期组(9例),重度子痫前期组(26例),慢性高血压合并子痫前期组(慢高合并子痫前期组,9例).应用三维能量彩色多普勒超声仪检测各组孕妇胎盘三维直方图血管指数(VI)、血流指数(FI)、血管化血流指数(VFI),应用二维多普勒超声检测脐血流收缩期/舒张期血流速度峰值(S/D值).并记录分娩孕周、新生儿出生体重、低出生体重儿百分比和胎盘重量.结果 (1)VI、FI、VFI及脐血流S/D值:正常孕妇组分别为6.3±2.9、38.6±4.4、2.7±1.3及2.5±0.6;轻度子痫前期组分别为5.7±3.8、36.3±7.2、2.4±2.0及2.4±0.3;重度子痫前期组分别为3.0±2.4、31.7±5.0、1.1±1.0及2.9±1.3;慢高合并子痫前期组分别为2.2±1.6、26.1±4.4、0.8±0.6及3.1±1.6.正常孕妇组孕妇胎盘VI、FI、VFI值与轻度子痫前期组比较,差异均无统计学意义(P>0.05),而重度子痫前期组和慢高合并子痫前期组孕妇胎盘VI、FI 、VFI兀值均明显低于正常孕妇组(P<0.01)及轻度子痫前期组(P<0.05).而各组孕妇脐血流S/D值相互比较,差异均无统计学意义(P>0.05).(2)分娩孕周、新生儿出生体重、低出生体重儿百分比和胎盘重量:正常孕妇组分别为(38.7±1.5)周、(3280±520)g、3%及(568±141)g;轻度子痫前期组分别为(37.9 ±1.0)周、(2971±265)g.0及(576±98)g;重度子痫前期组分别为(33.2±2.6)周、(1820±737)g.58%及(458±154)g;慢高合并重度子痫前期组分别为(32.6±2.6)周、(1497±533)g.7/9及(396±141)g.正常孕妇组与轻度子痫前期组分娩孕周、新生儿出生体重、低出生体莺儿百分比和胎盘重量比较,差异均无统计学意义(P>0.05),而重度子痫前期组和慢高合并重度子痫前期组的分娩孕周、新生儿出生体重、低出生体重儿百分比和胎盘重量均明显低于正常孕妇组(P<0.01)与轻度子痫前期组(P<0.05).结论 (1)重度子痫前期及慢高合并子痫前期孕妇胎盘组织的血流灌注明显减少,临床上相应出现胎盘重量及新生儿出生体重下降、分娩孕周偏低、低出生体重儿数量增加等结果;而脐血流S/D值无明显变化.(2)三维能量彩色多普勒超声对胎盘组织血流灌注的检测有重要的临床诊断意义.
目的 探討三維能量綵色多普勒超聲檢測子癇前期孕婦胎盤組織血流灌註的臨床價值.方法 選擇2007年7月至2008年5月在首都醫科大學附屬北京婦產醫院超聲科行產前超聲檢查的正常孕婦及子癇前期孕婦共80例,其中36例正常孕婦為正常孕婦組,44例子癇前期孕婦分為輕度子癇前期組(9例),重度子癇前期組(26例),慢性高血壓閤併子癇前期組(慢高閤併子癇前期組,9例).應用三維能量綵色多普勒超聲儀檢測各組孕婦胎盤三維直方圖血管指數(VI)、血流指數(FI)、血管化血流指數(VFI),應用二維多普勒超聲檢測臍血流收縮期/舒張期血流速度峰值(S/D值).併記錄分娩孕週、新生兒齣生體重、低齣生體重兒百分比和胎盤重量.結果 (1)VI、FI、VFI及臍血流S/D值:正常孕婦組分彆為6.3±2.9、38.6±4.4、2.7±1.3及2.5±0.6;輕度子癇前期組分彆為5.7±3.8、36.3±7.2、2.4±2.0及2.4±0.3;重度子癇前期組分彆為3.0±2.4、31.7±5.0、1.1±1.0及2.9±1.3;慢高閤併子癇前期組分彆為2.2±1.6、26.1±4.4、0.8±0.6及3.1±1.6.正常孕婦組孕婦胎盤VI、FI、VFI值與輕度子癇前期組比較,差異均無統計學意義(P>0.05),而重度子癇前期組和慢高閤併子癇前期組孕婦胎盤VI、FI 、VFI兀值均明顯低于正常孕婦組(P<0.01)及輕度子癇前期組(P<0.05).而各組孕婦臍血流S/D值相互比較,差異均無統計學意義(P>0.05).(2)分娩孕週、新生兒齣生體重、低齣生體重兒百分比和胎盤重量:正常孕婦組分彆為(38.7±1.5)週、(3280±520)g、3%及(568±141)g;輕度子癇前期組分彆為(37.9 ±1.0)週、(2971±265)g.0及(576±98)g;重度子癇前期組分彆為(33.2±2.6)週、(1820±737)g.58%及(458±154)g;慢高閤併重度子癇前期組分彆為(32.6±2.6)週、(1497±533)g.7/9及(396±141)g.正常孕婦組與輕度子癇前期組分娩孕週、新生兒齣生體重、低齣生體鶯兒百分比和胎盤重量比較,差異均無統計學意義(P>0.05),而重度子癇前期組和慢高閤併重度子癇前期組的分娩孕週、新生兒齣生體重、低齣生體重兒百分比和胎盤重量均明顯低于正常孕婦組(P<0.01)與輕度子癇前期組(P<0.05).結論 (1)重度子癇前期及慢高閤併子癇前期孕婦胎盤組織的血流灌註明顯減少,臨床上相應齣現胎盤重量及新生兒齣生體重下降、分娩孕週偏低、低齣生體重兒數量增加等結果;而臍血流S/D值無明顯變化.(2)三維能量綵色多普勒超聲對胎盤組織血流灌註的檢測有重要的臨床診斷意義.
목적 탐토삼유능량채색다보륵초성검측자간전기잉부태반조직혈류관주적림상개치.방법 선택2007년7월지2008년5월재수도의과대학부속북경부산의원초성과행산전초성검사적정상잉부급자간전기잉부공80례,기중36례정상잉부위정상잉부조,44례자간전기잉부분위경도자간전기조(9례),중도자간전기조(26례),만성고혈압합병자간전기조(만고합병자간전기조,9례).응용삼유능량채색다보륵초성의검측각조잉부태반삼유직방도혈관지수(VI)、혈류지수(FI)、혈관화혈류지수(VFI),응용이유다보륵초성검측제혈류수축기/서장기혈류속도봉치(S/D치).병기록분면잉주、신생인출생체중、저출생체중인백분비화태반중량.결과 (1)VI、FI、VFI급제혈류S/D치:정상잉부조분별위6.3±2.9、38.6±4.4、2.7±1.3급2.5±0.6;경도자간전기조분별위5.7±3.8、36.3±7.2、2.4±2.0급2.4±0.3;중도자간전기조분별위3.0±2.4、31.7±5.0、1.1±1.0급2.9±1.3;만고합병자간전기조분별위2.2±1.6、26.1±4.4、0.8±0.6급3.1±1.6.정상잉부조잉부태반VI、FI、VFI치여경도자간전기조비교,차이균무통계학의의(P>0.05),이중도자간전기조화만고합병자간전기조잉부태반VI、FI 、VFI올치균명현저우정상잉부조(P<0.01)급경도자간전기조(P<0.05).이각조잉부제혈류S/D치상호비교,차이균무통계학의의(P>0.05).(2)분면잉주、신생인출생체중、저출생체중인백분비화태반중량:정상잉부조분별위(38.7±1.5)주、(3280±520)g、3%급(568±141)g;경도자간전기조분별위(37.9 ±1.0)주、(2971±265)g.0급(576±98)g;중도자간전기조분별위(33.2±2.6)주、(1820±737)g.58%급(458±154)g;만고합병중도자간전기조분별위(32.6±2.6)주、(1497±533)g.7/9급(396±141)g.정상잉부조여경도자간전기조분면잉주、신생인출생체중、저출생체앵인백분비화태반중량비교,차이균무통계학의의(P>0.05),이중도자간전기조화만고합병중도자간전기조적분면잉주、신생인출생체중、저출생체중인백분비화태반중량균명현저우정상잉부조(P<0.01)여경도자간전기조(P<0.05).결론 (1)중도자간전기급만고합병자간전기잉부태반조직적혈류관주명현감소,림상상상응출현태반중량급신생인출생체중하강、분면잉주편저、저출생체중인수량증가등결과;이제혈류S/D치무명현변화.(2)삼유능량채색다보륵초성대태반조직혈류관주적검측유중요적림상진단의의.
Objective To investigate the placenta perfusion in pre-eclampsia by three-dimensional power Doppler ultrasound and analysing the clinical outcome. Method 80 cases of normal and pre-eclampsia pregnant women from July 2007 to May 2008 in Beijing Obstetrics and Gynecology Hospital were studied. The control group of 36 cases, pre-eclampsia were divided into three groups: a total of 44 cases, mild pre-eclampsia group (9 cases), severe pre-eclampsia group (26 cases) and chronic hypertension with pre-eclampsia group (9 cases). The placental vascular index (VI), flow index (FI), blood vessels and blood flow index (VFI) by three-dimensional Doppler histogram and the umbilical blood flow systolic to diastolic (S/D) by color Doppler flow imaging were calculated and the gestational age after delivery, birth weight, placental weight after birth were recorded respectively. Results (1)VI、 FI、 VFI and umbilical blood flow S/D value :6.3±2.9, 38.6±4.4, 2.7±1.3, 2.5±0.6 in normal group ;5.7±3.8, 36.3±7.2, 2.4±2.0, 2.4±0.3 in mild pre-eclampsia group;3.0±2.4, 31.7±5.0, 1.1±1.0, 2.9±1.3 in severe pre-eclampsia group ;2.2±1.6, 26.1±4.4, 0.8±0.6, 3.1±1.6 in chronic hypertension with pre-eclampsia group. Placenta of normal group and mild preeclampsia group VI, FI, VFI were no significant difference (P>0.05), placental VI, FI, VFI of severe preeclampsia group and chronic hypertension with severe pre-eclampsia group were significantly lower than the normal group (P<0.01) and than mild pre-eclampsia group (P<0.05). The umbilical blood flows were not obvious difference among four groups (P>0.05) ; (2) Gestationul age after birth, birth weight, low newborn weight rate and placental weight:(38.7±1.5 ) weeks, (3280±520) g, 3%, (568±141) g in normal group; (37.9±1.0) weeks, (2971±265) g, 0,(576±98) g in mild pre-eclampsia group; (33.2±2.6) weeks, (1820±737) g,58%, (458±154) g in severe pre-eclampsia group; (32.6±2.6) weeks, (1497±533) g, 7/9, (396±141) g in chronic hypertension with pre-eclampsia group. The normal group and mild pre-eclampsia group in gestationul age after birth, birth weight, low newborn weight rate and placental weight were not significant difference (P>0.05); severe pre-eelampsia and chronic hypertension with severe pre-eclampsia group in them were significantly lower than the normal group (P<0.01) and than mild pre-eclampsia group (P<0.05).Conclusions (1) Placental blood flow perfusion of the severe pre-eclampsia and pre-eclampsia with chronic hypertension of pregnancy decreased resulting in clinically lower placental weight, birth weight and gestational age at delivery, but there were no obvious differences in umbilical blood flow S/D values. (2) The investigation was helpful to clinical diagnosis in the placenta perfusion of pre-eclampsia by three-dimensional power Doppler ultrasound.
