CAJ | 학술논문

目的：分析持续性胎心监护应用于胎儿轻度心动过缓的基础上出现胎心监护变异减少、可变减速、晚期减速、延长减速等异常图形的孕妇的妊娠结局，发现胎儿宫内窘迫异常图形及处理。方法：2007年10月~2010年10月在我院住院分娩的产妇124例，入院胎心监护均为胎儿心动过缓的孕妇88例(对照组)，追踪其妊娠结局，并与同期胎儿轻度心动过缓的基础上出现胎心监护变异减少、可变减速、晚期减速、延长减速等异常图形的36例孕妇做对照比较(观察组)。结果：观察组与对照组在羊水粪染及新生儿窒息方面差异无统计学意义(P>0.05)，但观察组的剖宫产率明显高于对照组(P<0.05)，观察组的产钳助产率明显高于对照组(P<0.05)，观察组的脐带绕颈发生率明显高于对照组(P<0.05)。结论：产前持续性胎心监护应用于胎儿轻度心动过缓，出现下列图形之一：胎心基线变异消失，重度可变减速，晚期减速，延长减速可诊断胎儿宫内窘迫，应积极处理。国内产科学界迄今尚缺乏胎心监护的循证医学证据及统一标准，不能单纯依靠图形分析，要结合病史和患者的临床情况综合分析，做出胎儿宫内窘迫的诊断。
목적：분석지속성태심감호응용우태인경도심동과완적기출상출현태심감호변이감소、가변감속、만기감속、연장감속등이상도형적잉부적임신결국，발현태인궁내군박이상도형급처리。방법：2007년10월~2010년10월재아원주원분면적산부124례，입원태심감호균위태인심동과완적잉부88례(대조조)，추종기임신결국，병여동기태인경도심동과완적기출상출현태심감호변이감소、가변감속、만기감속、연장감속등이상도형적36례잉부주대조비교(관찰조)。결과：관찰조여대조조재양수분염급신생인질식방면차이무통계학의의(P>0.05)，단관찰조적부궁산솔명현고우대조조(P<0.05)，관찰조적산겸조산솔명현고우대조조(P<0.05)，관찰조적제대요경발생솔명현고우대조조(P<0.05)。결론：산전지속성태심감호응용우태인경도심동과완，출현하렬도형지일：태심기선변이소실，중도가변감속，만기감속，연장감속가진단태인궁내군박，응적겁처리。국내산과학계흘금상결핍태심감호적순증의학증거급통일표준，불능단순의고도형분석，요결합병사화환자적림상정황종합분석，주출태인궁내군박적진단。
Objective:Continuous cardiac monitoring application in fetal mild bradycardia mutation in cardiac care to reduce,on the basis of variable deceleration,anomalous graphics terminal slows,prolonging the pregnancy outcomes among pregnant women,and found abnormal fetal intrauterine distress graphics and processing.Methods:In October 2007 to October 2010 in our hospital 124 cases hospitalized childbirth puerpera,hospital cardiac monitoring of fetal bradycardia,88 cases of pregnant women (control group),track their pregnancy outcomes,and compared with fetal mild bradycardia mutation in cardiac care to reduce,on the basis of variable deceleration,late deceleration,prolong the deceleration abnormal shapes of 36 cases of pregnant women as control (observation group).Results:Observation group and control group in the amniotic fluid excrement to dye and neonatal asphyxia differences of no statistical significance (P>0.05),but the cesarean delivery rate of observation group was obviously higher than that of control group (P<0.05),and forceps birth rate of observation group was obviously higher than that of control group (P<0.05),the incidence of umbilical cord around the neck of the observation group was obviously higher than that of control group (P<0.05).Conclusion:Antenatal continuous cardiac monitoring was applied to mild bradycardia,fetus in one of the following graphic:cardiac baseline variation disappear,severe variable deceleration,late deceleration,extend the slowdown to diagnosis fetal distress,should actively processing.Domestic obstetrics community so far and there is no heart guardianship and evidence-based medical evidence of unified standards,cannot rely on graphics analysis,combining with the history and the patient's clinical situation,a comprehensive analysis to make the diagnosis of fetal intrauterine distress.