CAJ | 학술논문

目的:胎儿心率监护是围产期的一项重要内容,通过对心率-宫缩曲线(cardiotocogragh,CTG)分析得知胎儿在子宫内是否存在缺氧、窘迫、酸中毒等,以便及时采取相应措施.方法:我们开发了Meticare分析软件包,对采集到的867例CTG数据进行分析计算,探讨了胎心率短变异(STY)与基础胎心率(BHR)之间的关系,并进行基于STV的短时监护分析,利用SAS做了相关回归分析.结果:STV均值与BHR间存在负相关,即STV=9.866-0.02×BHR,且BHR升高,心率曲线波动的幅度(LTV)趋向于减小.5 min及10min的CTG数据的STV存在高度正相关,即STV_(10nim)=2.861-0.596×STV_(5min).结论:由监护5 min收集到的数据分析计算得出的STV值,对于Dawes & Redman判断标准要求的监护10 min的STV值具有一定的预测意义和参考价值;并且由于STV的计算不需要宫压数据,如果胎心仪集成了STV的计算功能,对于门诊的胎心听诊具有重要意义.妊娠30W后,随着STV降低,胎儿窘迫、窒息、低体重、甚至死亡率明显递增,而在床边机无分析功能或者用胎心仪听诊的情况下,当BHR升高时,应引起警惕,STV值可能降低,须采取相应措施.
목적:태인심솔감호시위산기적일항중요내용,통과대심솔-궁축곡선(cardiotocogragh,CTG)분석득지태인재자궁내시부존재결양、군박、산중독등,이편급시채취상응조시.방법:아문개발료Meticare분석연건포,대채집도적867례CTG수거진행분석계산,탐토료태심솔단변이(STY)여기출태심솔(BHR)지간적관계,병진행기우STV적단시감호분석,이용SAS주료상관회귀분석.결과:STV균치여BHR간존재부상관,즉STV=9.866-0.02×BHR,차BHR승고,심솔곡선파동적폭도(LTV)추향우감소.5 min급10min적CTG수거적STV존재고도정상관,즉STV_(10nim)=2.861-0.596×STV_(5min).결론:유감호5 min수집도적수거분석계산득출적STV치,대우Dawes & Redman판단표준요구적감호10 min적STV치구유일정적예측의의화삼고개치;병차유우STV적계산불수요궁압수거,여과태심의집성료STV적계산공능,대우문진적태심은진구유중요의의.임신30W후,수착STV강저,태인군박、질식、저체중、심지사망솔명현체증,이재상변궤무분석공능혹자용태심의은진적정황하,당BHR승고시,응인기경척,STV치가능강저,수채취상응조시.
Objective: Fetal monitoring is extremely important in perinatal care. Analysis of cardiotocogragh(CTG) can suppose if the fetus is lack of oxygen, distressed, acidosis, etc. in order to take measures timely. Methods: We have designed Meticare analysis software package to analyze 867 pieces of CTG data, and researched the relationship between short term variation (STV) and basal heart rate(BHR) by statistics, and short time monitoring analysis based on STV. Results: The amplitude of fetal heart rate curve variation(long term variation) tended to decrease when BHR increasing, with the negative correlation and regression equation STV = 9.866-0.02×BHR. Positive correlation exists between 5 and 10 mimute-STV, with the regression equation STV_(10min)=2.861-0.596×STV_(5min).Conclusion: STV calculated by 5 minutes CTG data can forecast the one by 10 minutes data as a reference demanded by Dawes & Redman criterion. If fetal doppler contains STV analysis function, out-patient fetal heart auscultation will be more significant. After 30 weeks pregnancy, with the STV decreasing, fetal distress, asphyxia, low birth weight, and even mortality increasing. BHR increasing should cause attention that STV might decrease, when monitoring with no analysis functional devices or fetal dopplars.