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目的超声观察正常中晚期妊娠胎儿心排血量及其分布情况的变化。方法行超声心动图检查的孕中晚期单胎正常孕妇250例,根据孕周分为五组:20~24周(50例),24~(+1)~28周(55例),28~(+1)~32周(65例)、32~(+1)~36周(45例),36~(+1)~40周(35例)。测定肺动脉瓣、主动脉峡部最大内径和动脉导管各部位血流频谱,包括E峰、A峰及E/A;计算不同孕周胎儿左、右心室排血量、主动脉峡部排血量及动脉导管排血量。结果正常中晚期胎儿肺动脉瓣、主动脉峡部最大内径、动脉导管的血流频谱(E峰和E/A)随孕周的增加而增加(P<0.05),而A峰值随孕周的增加无明显变化(P>0.05)。正常中晚期胎儿左、右心室心排血量、主动脉峡部排血量和动脉导管排血量随孕周的增加而增加(P<0.05),且与孕周呈正相关(r=0.362、0.378、0.369和0.352,P<0.05)。结论分析不同孕周正常中晚期胎儿血流频谱及心排血量分布情况可为胎儿早期血流量异常变化引起的后期形态学改变提供指导,对早期筛查心功能异常胎儿具有重要的指导价值。
Objective To observe the change of fetal cardiac output and its distribution in normal middle and late pregnancy by ultrasound. Methods 250 pregnant women with singleton at the second trimester of pregnancy were divided into five groups according to gestational age: 20 to 24 weeks (50 cases), 24 to (+1) to 28 weeks (55 cases) (+1) ~ 32 weeks (65 cases), 32 ~ (+1) ~ 36 weeks (45 cases), 36 ~ (+1) ~ 40 weeks (35 cases). The pulmonary artery valves, the maximum internal diameter of aortic isthmus, and the spectrum of blood flow in all parts of the arterial catheter were measured, including E peak, A peak and E / A. Left and right ventricular ejection volume, aortic isthmus and arterial Catheter volume. Results The pulmonary artery valve, the isthmus of the aorta and the blood flow spectrum (E peak and E / A) of the ductus arteriosus increased with gestational age (P <0.05), while the peak of A peak increased with gestational age Significant changes (P> 0.05). The left ventricular and right ventricular cardiac output, the isthmic isthmus and the arterial catheter volume in the normal middle and late fetuses increased with gestational age (P <0.05), and positively correlated with gestational age (r = 0.362 and 0.378 , 0.369 and 0.352, P <0.05). Conclusion The analysis of the distribution of fetal blood flow and cardiac output in normal middle and late gestational weeks can provide guidance for the morphological changes caused by abnormal changes of early blood flow in fetus and has important guiding value in the early screening of fetuses with abnormal cardiac function.