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目的探讨胎心监护图形联合脐血流测定共同预测新生儿出生情况的临床价值。方法将2013年1月~2014年12月期间入住玉田县医院的200例孕妇作为研究对象,进行胎心监护图形联合脐血流测定,患者按照NST反应类型和脐动脉S/D值及RI值进行分组,共分为3组。A组70例,为NST反应型+脐动脉S/D值≥3.0,RI≥0.6;B组70例,为NST无反应型+脐动脉S/D<3.0,RI<0.6;C组60例为NST无反应型+脐动脉S/D≥3.0,RI≥0.6。记录各组新生儿1 min Apgar评分、脐血血气分析情况,比较新生儿出生情况。结果 C组孕妇胎心监护图形及脐血流测定均异常,产出胎儿1 min Apgar评分8~10分所占百分率(86.67%),脐血血气分析7.00~7.20所占百分率(86.67%),均低于其他胎心监护图形及脐血流测定一项有异常的A、B组,具有统计学意义(P=0.025);C组孕妇产出胎儿窒息发生率(13.33%)、剖宫产率(33.33%)明显高于A、B两组,C组孕妇羊水情况正常率(86.67%)、胎盘正常率(86.67%)明显低于A、B两组(P=0.012)。结论胎心监护图形联合脐血流测定共同预测新生儿出生时情况,降低单一检测结果的假阳性率,为基层医院有效降低剖宫产率,又能早期发现胎儿宫内窘迫,防止不良妊娠结局,及时采取有效措施提供循证医学证据。
Objective To investigate the clinical value of fetus heart monitoring graphics combined with umbilical cord blood flow prediction in predicting newborns’ birth. Methods A total of 200 pregnant women admitted to Yutian County Hospital from January 2013 to December 2014 were enrolled in this study. Fetal heart monitoring graphics and umbilical cord blood flow were measured. According to the NST response type and the S / D value of umbilical artery and RI value Divided into three groups. A group of 70 patients with NST reactive + umbilical artery S / D ≥ 3.0, RI ≥ 0.6; B group of 70 patients with NST non-reactive + umbilical artery S / D <3.0, RI <0.6; C group of 60 patients NST non-reactive + umbilical artery S / D≥3.0, RI≥0.6. Record 1 minute Apgar score of neonates in each group, blood gas analysis of cord blood, compare newborns birth situation. Results The fetal heart rate monitoring graph and umbilical blood flow measurement were abnormal in group C, the percentage of Apgar score 8-10 (86.67%) and cord blood blood gas 7.00-7.20 (86.67% (P = 0.025). The incidence of fetal asphyxia (13.33%) in C group was higher than that in C group (33.33%) was significantly higher than that of A and B groups. The positive rate of amniotic fluid in pregnant women in group C (86.67%) was significantly lower than that in group A and B (86.67%) (P = 0.012). Conclusion Fetal heart monitoring graphics and umbilical cord blood flow together predict the newborn’s condition at birth and reduce the false-positive rate of single test results, which can effectively reduce the rate of cesarean section in primary hospitals and early detection of fetal distress and prevent adverse pregnancy outcomes , Take timely and effective measures to provide evidence-based medical evidence.