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目的：探讨脐血流多普勒超声联合Ｂ超对产前诊断脐绕颈的价值。方法：对我院１９９４年１０月～１９９６年１０月住院分娩的３４０例正常足月妊娠妇女进行了Ｂ超及脐血流多普勒超声检查。结果：Ｂ超产前诊断脐绕颈率为５６．７５％，Ｂ超联合脐血流多普勒超声使脐绕颈的检出率提高到７３．８７％，二者联合对脐绕颈阴性的预测率为８７．１１％。根据产后情况分正常组（２２９例）和脐绕颈组（１１１例），比较两组间脐动脉收缩期血流速度峰值与舒张期血流速度峰值的比值（Ｓ／Ｄ）、脐动脉搏动指数（ＰＩ）、脐动脉阻力数（ＲＩ），发现两组间Ｓ／Ｄ值差异有显著性（Ｐ＜０．０５）且与脐带长度有关，脐绕颈组中，脐带长度≤５０ｃｍ组分别与正常组和脐长７０ｃｍ以上的脐绕颈组比较，Ｓ／Ｄ、ＲＩ值差异均有显著性（Ｐ＜０．０１、Ｐ＜０．０５）。结论：脐绕颈时，产前已有脐带轻度受压。脐绕颈及绕颈后脐带相对过短均为脐带受压的主要原因。脐血流多普勒超声与Ｂ超结合，既可提高脐绕颈的产前检出率，也可在一定程度上估计胎儿宫内安危。
Objective: To investigate the value of umbilical blood flow Doppler ultrasound combined with B-ultrasound in the diagnosis of umbilical cord around the neck. Methods: A total of 340 normal term pregnant women who were hospitalized for delivery from October 1994 to October 1996 in our hospital underwent ultrasound and umbilical blood flow Doppler echocardiography. Results: B-ultrasonography diagnosis of umbilical neck rate was 56.75%, B-ultrasonography combined umbilical cord blood flow Doppler ultrasound to detect the rate of the umbilical neck increased to 73.87%, the two combined umbilical cord-neck negative The forecast rate is 87.11%. The ratio of peak value of diastolic flow velocity peak to diastolic flow velocity (S / D), umbilical artery pulsation rate of umbilical artery were compared between normal group (n = 229) and navel around neck group (111) Index (PI) and umbilical artery resistance (RI). There was a significant difference in S / D between the two groups (P <0.05) and was related to the length of umbilical cord. Compared with the normal group and umbilical cord around the neck longer than 70cm, the S / D and RI values were significantly different (P <0.01, P <0.05). Conclusion: umbilical cord around the prenatal umbilical cord has been mild pressure. Umbilical around the neck and around the neck after the umbilical cord is relatively short are the main reason for the umbilical cord compression. Umbilical blood flow Doppler ultrasound combined with B, can increase the umbilical cord around the prenatal detection rate, but also to a certain extent, estimated intrauterine safety.