实用医学杂志 ›› 2021, Vol. 37 ›› Issue (17): 2219-2223.doi: 10.3969/j.issn.1006⁃5725.2021.17.010

• 临床研究 • 上一篇    下一篇

胎盘血流灌注监测妊娠期高血压孕妇药物治疗效果研究

陈祯1 高霞1 赵杨1 刘芳芳1 李云鹏2   

  1. 1 十堰市人民医院(湖北医药学院附属人民医院)产科(湖北十堰 442000);2 湖北医药学院附属国药东风 总医院心血管内科(湖北十堰 442008)

  • 出版日期:2021-09-10 发布日期:2021-09-10
  • 通讯作者: 高霞 E⁃mail:gaoyang8965@163.com
  • 基金资助:

    湖北省卫生健康委科研项目(编号:WJ2019F067


Effect of drug therapy on pregnant women with gestational hypertension monitored by placental blood perfusion

CHEN Zhen*,GAO Xia,ZHAO Yang,LIU Fangfang,LI Yunpeng.   

  1. Department of ObstetricsRenmin HospitalHubei University of MedicineShiyan 442000China
  • Online:2021-09-10 Published:2021-09-10
  • Contact: GAO Xia E⁃mail:gaoyang8965@163.com

摘要:

目的 探讨胎盘血流灌注监测在妊娠期高血压孕妇药物治疗中的价值。方法 选取 2016- 2018 年本院接收的 228 例妊娠期高血压患者,其中子痫前期轻度患者和子痫前期重度患者分别为 93 例和 145 例,所有患者均行常规药物治疗,另外选正常孕妇作为对照组。通过三维能量多普勒超声完成胎盘血 流灌注监测疗效评估。结果 治疗前三组患者 VI、FI、VFI、脐动脉 S/D 等四类血液流变学指标差异有统 计学意义,治疗后三组患者的血液流变学指标差异无统计学意义。治疗前 A 组和 B 组产妇的超声参数明 显低于对照组,且 B 组产妇的左子宫动脉 PI、右子宫动脉 PI 超声参数明显低于 A 组,B 组产妇的大脑中动 PI Apgar 评分明显高于 A 组(P < 0.05)。胎盘 F1、二维彩色超声多普勒指数和 Apgar 评分无显著相关 性,而胎盘 V1、胎盘 VFI、二维彩色超声多普勒指数和 Apgar 评分有显著相关性。A 组和 B 组两组患者的总 有效率分别为 96.77% 95.56%,药物治疗后,不同疗效分级情况下胎盘 VI、FI、VFI 差异有统计学意义。 结论 通过三维能量多普勒超声对胎盘血流进行的监测,能有效评估妊娠期高血压孕妇药物治疗效果, 具有较强的临床应用价值

关键词:

胎盘血流监测, 妊娠期高血压, 三维能量多普勒超声, 硝苯地平

Abstract:

Objective To investigate the value of placental blood perfusion monitoring in drug treatment of pregnant women with gestational hypertension. Methods 228 patients with gestational hypertension in our hospital from 2016 to 2018 were selected,including 93 patients with mild preeclampsia and 145 patients with severe preeclampsia. All patients received conventional drug treatment,while normal pregnant women were selected as the control group. Three dimensional power Doppler ultrasound was used to evaluate the efficacy of placental blood perfusion monitoring. Results The hemorheological indexes of VI,fi,VFI,s/d of umbilical artery were significantly different in the three groups before treatment,and there was no significant difference in hemorheological indexes of the three groups. Before treatment ,the ultrasound parameters of the women in Group A and Group B were significantly lower than those of the control group,and the Pi of the left and right uterine arteries in Group B was significantly lower than that of Group A,while the scores of PI and Apgar in the middle cerebral artery of Group B were significantly higher than those in Group A(P < 0.05). There was no significant correlation between F1,2D color Doppler index and Apgar score,but there was significant correlation between placental V1,placenta VFI 2D color Doppler index and Apgar score. The total effective rate of Group A and Group B was 96.77% and 95.56% respectively. After drug treatment,placenta VI,FI and VFI showed significant differences under different therapeutic grades. Conclusion The monitoring of placental blood flow by three⁃dimensional power Doppler ultrasound can effectively evaluate the drug treatment effect of pregnant women with gestational hypertension,and has strong clini⁃ cal application value.

Key words:

placental blood flow monitoring, gestational hypertension, three dimensional power Doppler ultrasound, nifedipine