目的：应用彩色多普勒评价晚期妊娠脐带绕颈胎儿静脉导管( ductus venosus,DV)、脐动脉( umbilical arter-y,UA)及大脑中动脉( middle cerebral artery,MCA)血流动力学变化,为临床诊断胎儿宫内情况提供客观依据。方法应用彩色多普勒检测晚期妊娠93例脐带绕颈胎儿和184例非脐带绕颈胎儿的DV、UA和MCA的收缩期峰值流速( PS)、舒张末期流速(ED)、收缩期峰值流速与舒张末期流速比值(S/D)、搏动指数(PI)、阻力指数(RI)。结果脐带绕颈组胎儿PSDV值与正常对照组比较差异有统计学意义(P<0.05)；脐带绕颈组胎儿S/DUA值与正常对照组比较差异有统计学意义(P<0.05)；脐带绕颈组双侧大脑中动脉RIMCA平均秩次值与正常对照组比较差异有统计学意义(P<0.05),其余参数值差异均无统计学意义(P>0.05)。结论超声揭示胎儿静脉导管收缩期峰值流速及双侧大脑中动脉阻力指数异常,可能有助于判断晚期妊娠脐带绕颈胎儿宫内缺氧状态。%Objective To explore the hemodynamic changes of ductus venosus( DV) ,umbilical arteries( UA) and middle cerebral artery( MCA) in fetus with cord around neck in the third trimester using color Doppler flow ultrasonic imaging and to pro-vide the hemodynamic clue for fetal oxygen deficit diagnosis. Methods Ninty-three fetus with cord around neck and 184 control subjects were measured for DV、UA and MCA peak systolic velocity,end diastolic velocity,the peak-systolic/diastolic ratio( S/D),pulsatility index(PI),resistance index(RI) by color Doppler flow ultrasonic imaging. Results Significant differences were found in PS DV ,S/D UA and RI MCA between the two groups,but there was no significant difference in other hemodynamic parameters. Conclusion The ultrasound demonstration of abnormal systolic velocity peak of ductus venosus and higher RI of middle cerebral artery could be used to contribute to the diagnosis of fetal intrauterine hypoxia deficit in late pregnancy with cord around neck.
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