CAJ | 학술논문

目的：观察和评价胎心监护联合脐血流测定对诊断胎儿宫内窘迫的意义。方法选取208例单胎分娩孕妇作为研究对象，根据脐血流测定与胎心监护检查结果，将其分为A、B、C、D4个组，A组为脐血流测定、胎心监护均正常；B组为脐血流测定、胎心监护均异常；C组为脐血流测定异常而胎心监护正常；D组为脐血流正常而胎心监护异常。对研究对象产前、产时胎儿宫内窘迫发生率及胎儿预后进行观察和分析。结果4个组胎儿的1 m in新生儿评分（Apgar评分）均在4～10分，其中，A组中评分为8～10分的胎儿比例明显高于其他3个组，差异有统计学意义（P＜0．05），而B、C、D 3个组之间的差异无统计学意义（P＞0．05）；4个组胎儿间羊水污染程度的差异无统计学意义（P＞0．05）；A组和C组之间胎心异常率的差异无统计学意义（P＞0．05），B组和D组之间胎心异常率的差异无统计学意义（P＞0．05），但B组均明显高于A组与C组，且差异有统计学意义（P＜0．05）。结论胎心监控联合脐血流检查对于诊断胎儿宫内窘迫具有较高的意义和价值，可弥补单独应用一种方法的不足，提高诊断的可靠性，值得在临床上推广使用。
목적：관찰화평개태심감호연합제혈류측정대진단태인궁내군박적의의。방법선취208례단태분면잉부작위연구대상，근거제혈류측정여태심감호검사결과，장기분위A、B、C、D4개조，A조위제혈류측정、태심감호균정상；B조위제혈류측정、태심감호균이상；C조위제혈류측정이상이태심감호정상；D조위제혈류정상이태심감호이상。대연구대상산전、산시태인궁내군박발생솔급태인예후진행관찰화분석。결과4개조태인적1 m in신생인평분（Apgar평분）균재4～10분，기중，A조중평분위8～10분적태인비례명현고우기타3개조，차이유통계학의의（P＜0．05），이B、C、D 3개조지간적차이무통계학의의（P＞0．05）；4개조태인간양수오염정도적차이무통계학의의（P＞0．05）；A조화C조지간태심이상솔적차이무통계학의의（P＞0．05），B조화D조지간태심이상솔적차이무통계학의의（P＞0．05），단B조균명현고우A조여C조，차차이유통계학의의（P＜0．05）。결론태심감공연합제혈류검사대우진단태인궁내군박구유교고적의의화개치，가미보단독응용일충방법적불족，제고진단적가고성，치득재림상상추엄사용。
Objective To evaluate the significance of fetal heart rate monitoring combined with umbilical cord blood flow determination in the diagnosis of fetal distress .Methods A total of 208 singleton pregnant women were enrolled .According to the results of fetal heart rate monitoring and umbilical cord blood flow determination ,all sub-jects were divided into group A ,with normal results of fetal heart rate monitoring and umbilical cord blood flow de-termination ,group B ,with abnormal results of fetal heart rate monitoring and umbilical cord blood flow determina-tion ,group C ,with abnormal result of umbilical cord blood flow determination and normal result of fetal heart rate monitoring ,,and group D ,with normal result of umbilical cord blood flow determination and abnormal result of fetal heart rate monitoring .The prenatal and intrapartum incidence of fetal distress and fetal prognosis were observed and analyzed .Results The 1 minute Apgar scores of the fetuses in the four groups were 4-10 score .The portion of fetu-ses with 8-10 score in group A was significantly higher than the other three groups (P<0 .05) ,and the differences be-tween the other three groups were not significant (P>0 .05) .There was no significant difference of amniotic fluid pollution degrees between the four groups(P>0 .05) .The difference of abnormal fetal heart rate between group A and C was not significant(P>0 .05) .There was no significant difference of abnormal fetal heart rate between group B and D(P>0 .05) ,but significantly higher than group A and C(P<0 .05) .Conclusion Combined application of fetal heart rate monitoring and umbilical cord blood flow determination might be with significance for the diagnosis of fetal distress ,which could make up for the shortage of single application ,improve the reliability of the diagnosis ,and be worthy for clinical application .