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目的利用右心室组织多普勒成像(TDI)Tei指数及静脉导管(DV)指数综合评价脐绕颈胎儿右心室功能的改变。方法选择37~41+6周孕妇189例,其中绕颈组77例(依照脐动脉S/D值分为S/D≥3组和S/D<3组),对照组112例。首先应用TDI技术分别测量各组胎儿右心室等容收缩时间(ICT)、等容舒张时间(IRT)及射血时间(ET),计算Tei指数;再分别测量各组胎儿静脉导管阻力指数(RI)、搏动指数(PI)及S/A比值,最后通过以上参数综合评价脐绕颈胎儿右心室功能的改变。结果脐绕颈且S/D≥3组胎儿较脐绕颈且S/D<3组及对照组胎儿右心室Tei指数及DV指数明显增高,差异有统计学意义(P<0.05);脐绕颈且S/D<3组胎儿右心室Tei指数及DV指数与对照组相比,差异无统计学意义(P>0.05)。结论通过对脐绕颈胎儿右心室Tei指数及DV指数的研究,可为临床评估脐绕颈胎儿心功能异常及治疗提供重要信息。
Objective To evaluate the changes of right ventricular function in umbilical cord around fetus by using the right ventricular tissue Doppler imaging (TDI) Tei index and venous catheter (DV) index. Methods A total of 189 pregnant women with 37 ~ 41 + 6 weeks were selected, including 77 cases around the neck group (S / D≥3 group and S / D group <3 according to S / D value of umbilical artery) and 112 cases of control group. TDI was used to measure the right ventricular systolic time (ICT), isovolumic relaxation time (IRT) and ejection time (ET) in each group, and the Tei index was calculated. The resistance index ), Pulsatility index (PI) and S / A ratio. Finally, the above parameters were used to evaluate the changes of right ventricular function in umbilical cord around fetus. Results The Tei index and DV index of right ventricle in umbilical and cervical S / D≥3 group were significantly higher than those in umbilical and S / D <3 group and control group (P <0.05) There was no significant difference in the Tei index and DV index of the right ventricle between the S / D group and the control group (P> 0.05). Conclusion The study of right ventricular Tei index and DV index of umbilical cord around fetus can provide important information for clinical evaluation of cardiac function and treatment of umbilical cord fetus.