目的: 探讨胎心监测、脐血流S /D 值测定预测高危妊娠孕晚期胎儿窘迫的意义。方法: 选择我院
2013－09～ 2015－09 我院收治的单胎高危妊娠孕晚期孕妇200 例，所有孕妇产前均行胎心监测及脐血流检测。对
比两种检测手段与联合检测的预测结果。结果: S /D 值＜3 与胎心监测有反应型比较，差异不显著; S /D 值≥3 与
胎心监测无反应型比较差异不显著，均P＞0．05; 胎心监测异常者羊水Ⅲ度混浊、Apgar≤7 分、低体重新生儿均明
显高于正常者，二者比较，P＜0．05; S /D 值异常者羊水Ⅲ度混浊、Apgar≤7 分、低体重新生儿均明显高于正常者，
二者比较，P＜0．05; 联合检测新生儿预后不良发生率为36．0%，明显高于另两种检测手段，P＜0．05; 胎心监测预后
不良发生率为26．0%，脐血流检查为21．0%，两种检测检查结果差异无显著性，P＞0．05。结论: 联合检测排除了单
项监测时各方面因素的干扰，提高了新生儿预后不良的诊断率，弥补单一检测的不足，有助于为早期预测新生儿
预后不良提供依据。

Objective: To investigate the significance of fetal heart monitoring，umbilical cord blood
flow S /D value in predicting fetal distress in high risk pregnancy．Methods: in our hospital from September
2013 to September 2015 in our hospital 200 cases of high－risk singleton pregnancy pregnancy，
all pregnant women underwent antenatal fetal heart monitoring and umbilical blood flow detection．The
prediction results of two kinds of means for contrast detection and joint detection．Results: S /D＜3and
fetal heart monitoring reaction type comparison， the difference was not significant; the S /D value is
more than 3 and the fetal heart monitoring without response．There is no significant difference，P＞0．05;
fetal heart monitoring abnormal amniotic fluid of 7 Apgar， turbidity， low birth weight infants were signif
icantly higher than normal．The comparison between the two，P＜0．05; S /D value of abnormal amniotic
fluid turbidity，7 Apgar， low birth weight infants were significantly higher than those of normal subjects，
two，P＜0．05; combined detection of neonatal prognosis rate was 36%， significantly higher than the other
two kinds of detection methods，P＜0．05; fetal heart Monitoring the incidence of adverse prognosis was
26%， the umbilical cord blood flow was 21%，and there was no significant difference between the two
types of test results，P＞0．05．Conclusion: the combined detection of the interference of various factors
in the single monitoring，improve the prognosis of newborns with poor diagnostic rate，make
up for the lack of a single detection，help to provide a basis for the early prediction of neonatal
prognosis．

R722

 收稿日期: 2016－07－20; 修回日期: 2016－09－21
基金项目: 内蒙古医科大学科技百万工程项目( YKD 2013 KJBW013) ;
内蒙古自治区医疗卫生科研计划项目( 201302078)
作者简介: 易媛媛( 1971－) ，女，内蒙古医科大学附属医院产科主任医师，硕士研究生导师。