胎心率監護在高危妊娠中的應用

[摘要]目的 探討胎心率監護儀在高危妊娠中監測胎兒宮內情況的臨床效果。 方法 采用胎兒心率電子監護儀對高危妊娠孕婦進行產前、產時監護，其中行無負荷試驗（NST）68例，宮縮應激試驗（CST）和催產素激惹試驗（OCT）48例。 結果 NST 68例中反應型63例占92.65%，無反應型5例占7.35%，CST+OCT 48例中陰性43例占89.58%，陽性5例占10.42%。NST反應型的高危妊娠孕婦胎兒宮內窘迫、新生兒窒息發生率、手術產率均明顯低于NST無反應型的高危妊娠孕婦（P<0.05），CST+OCT陰性的高危妊娠產婦其胎兒宮內窘迫、新生兒窒息發生率及手術產率明顯低于CST+OCT陽性的高危妊娠產婦（P<0.05）。 結論 胎兒心率電子監護儀對高危妊娠孕婦可增加異常胎兒心率的檢出，早期發現胎兒宮內缺氧情況，有效降低新生兒窒息和早產的發生，提高臨危胎兒的搶救成功率，降低圍生兒的死亡率。

[關鍵詞]胎兒；電子監護儀；高危妊娠

[中圖分類號] R714.7 [文獻標識碼] B [文章編號] 2095-0616（2013）13-193-03

Application of the fetal heart rate monitor in the high-risk pregnancy

YU Qingling LIU Hongxiu PENG Yulan PENG Nisha

Zhangmutou People's Hospital of Dongguan City in Guangdong Province， Dongguan 523623，China

[Abstract] Objective To explore the clinical effects of the fetal heart rate monitor in a high-risk pregnancy to monitor fetal. Methods The pregnant women were used the fetal heart rate monitor to tutelage when they were in the ante partum and intrapartum，68 cases were being the Non stress test，48 cases were being the contyaction stress test and oxytocin challenge test. Results In NST68 cases，the reaction type with 63 cases accounting for 92.65%，the unresponsive type with 5 cases accounting for 7.35%.In CST + in OCT48 cases，43 cases were negative accounting for 89.58%，5 cases were positive accounting for 10.42%.NST reaction type of high-risk pregnancy maternal fetal distress，neonatal asphyxia，operative delivery were significantly lower than the NST reactive high-risk pregnant women （P<0.05），the CST + OCT negative high-risk pregnancy maternal fetal Palace inner distress，neonatal asphyxia，and operative delivery rate was significantly lower than the CST + OCT positive risk pregnancy women （P<0.05）.Conclusion Fetal heart rate the electronic detection of abnormal fetal heart rate monitor high-risk pregnant women can increase early detection of fetal hypoxia，reduce the incidence of neonatal asphyxia and premature birth，and improve the success rate of Threatened fetus，reducing preinstall children mortality.

[Key words] Fetus；Electronic monitor；High-risk pregnancy

高危妊娠是指婦女在妊娠期由于某些可能危及孕婦與胎兒的并發癥與致病因素，胎位異常導致難產、母兒疾病或死亡危險增高的妊娠[1]。電子胎心監護具有簡單、方便、可靠、無創、可重復監測等優點，易為產婦接受，胎心監護的目的是預測胎兒宮內缺氧狀態、及時發現胎兒窘迫或測試胎兒對缺氧的耐受能力，其敏感性、特異性和準確性的標準是胎兒出生后有無新生兒窒息或有無酸中毒[2]。我院選取2011年1月～2012年10月期間對116例高危妊娠孕婦進行產前、產時監護，為了及時發現高危胎兒，應用胎心監護儀對高危妊娠產婦進行NST和CST+OCT，監測胎兒宮內發育情況，采取相應的適當的應對措施，降低胎兒宮內窘迫和新生兒窒息的發生率，現總結分析報道如下。……