标题：孕晚期NST可疑型胎儿的长程胎心监护特点分析

      作者：贾苗 1，李娜 2，肖玲 1，何金秀 1    1.汉中市中心医院产科，陕西 汉中 723000；2.汉中市南郑区人民医院妇产科，陕西 汉中 723100

      卷次： 2023年34卷11期

      【摘要】 目的 分析孕晚期无应激试验(NST)可疑型胎儿的长程胎心监护特点。方法 选择 2019年 2月至2021年12月在汉中市中心医院建档的120例产妇作为研究对象。按照孕晚期NST的检测结果，将所有产妇分为研究组50例(NST可疑型)和对照组70例(NST反应型)。比较两组产妇的妊娠结局、胎心率基线、胎心率基线变异率、平均单位时间加速面积和心加速的时长比例。结果 两组产妇的终止妊娠方式、终止妊娠天数、新生儿窒息率比较差异均无统计学意义(P>0.05)；两组产妇的胎心监护有效时长、总时长比较差异均无统计学意义(P>0.05)；研究组产妇的胎心率基线、轻度变异率、中等变异率分别为(138.09±5.67)次/min、51.18%、56.58%，明显多(高)于对照组的(135.09±5.40)次/min、40.79%、46.73%，差异均有统计学意义(P<0.05)；研究组产妇的基线变异值为(5.18±1.09)次/min，明显小于对照组的(6.29±1.16)次/min，差异有统计学意义(P<0.05)；两组产妇的显著变异率比较差异无统计学意义(P>0.05)；研究组产妇的胎心加速时长比例的最大值与最小值分别为(29.63±5.62)%、(47.78±9.04)%，明显低于对照组的(32.85±7.91)%、(54.96±11.95)%，单位时间加速面积的最小值和最大值分别为(0.75±0.28)%、(2.76±0.63)%，明显低于对照组的(1.15±0.42)%、(4.91±1.05)%，差异均有统计学意义(P<0.05)；研究组产妇的平均胎心加速时长比例和平均单位时间加速面积分别为(37.43±4.58)%、(1.41±0.47) cm2/20 min，明显低于对照组(40.79±4.85)%、(2.05±0.68) cm2/20 min，差异均有统计学意义(P<0.05)。结论 孕晚期NST可疑型胎儿的长程胎心监护的特征为胎心率基线、轻度变异率、中等变异率均增加；基线变异值降低、轻度变异率增加和单位时间加速面积减少。
      【关键词】 无应激试验；孕晚期；可疑型；长程胎心监护；特点
      【中图分类号】 R714.5 【文献标识码】 A 【文章编号】 1003—6350（2023）11—1573—04

Analysis of the characteristics of long-term fetal heart rate monitoring of NST suspicious type fetuses in the thirdtrimester of pregnancy.
JIA Miao 1, LI Na 2, XIAO Ling 1, HE Jin-xiu 1. 1. Department of Obstetrics, Hanzhong CentralHospital, Hanzhong 723000, Shaanxi, CHINA; 2. Department of Obstetrics and Gynecology, Nanzheng District People'sHospital, Hanzhong 723100, Shaanxi, CHINA
【Abstract】 Objective To investigate and analyze the characteristics of long-term fetal heart rate monitoring ofnon-stress test (NST) suspicious type fetus in the third trimester. Methods We selected 120 pregnant women who werefiled in Hanzhong Central Hospital from February 2019 to December 2021 as the study subjects. According to the test re-sults of NST in the third trimester of pregnancy, the pregnant women were divided into the study group of 50 cases (NSTsuspicious type) and the control group of 70 cases (NST reactive type). The pregnancy outcome, fetal heart rate baseline,fetal heart rate baseline variability, average area of acceleration per unit time, and the proportion of cardiac accelerationtime were compared between the two groups. Results There was no statistically significant difference in pregnancy ter-mination mode, pregnancy termination days, and neonatal asphyxia rate between the two groups (P>0.05). There wereno statistically significant in effective duration and total duration of fetal heart rate monitoring between the two groups (P>0.05).The baseline, mild variability, and moderate variability of fetal heart rate in the study group were (138.09±5.67) beats/min, 51.18%,and 56.58%, which were significantly higher than (135.09±5.40) beats/min, 40.79%, and 46.73% in the control group (P<0.05).The baseline variation of pregnant women in the study group was (5.18±1.09) times/min, which was significantly lower than(6.29±1.16) times/min in the control group (P<0.05). Comparison of significant variation rates showed no statisticallysignificant difference between the two groups (P>0.05). The maximum and minimum values of the proportion of fetalheart acceleration duration in the study group were (29.63±5.62)% and (47.78±9.04)%, which were significantly lowerthan (32.85±7.91)% and (54.96±11.95)% in the control group, and the minimum and maximum values of the accelera-tion area per unit time were (0.75±0.28)% and (2.76±0.63)%, which were significantly lower than (1.15±0.42)% and(4.91±1.05)% in the control group (P<0.05). The average rate of fetal heart rate acceleration time and the average accel-eration area per unit time in the study group were (37.43±4.58)% and (1.41±0.47) cm2/20 min, which were significantlylower than (40.79±4.85)% and (2.05±0.68) cm2/20 min in the control group (P<0.05). Conclusion The characteristicsof long-term fetal heart rate monitoring of NST suspicious type fetuses in the third trimester include increased baseline,mild and moderate variability of fetal heart rate, decreased baseline variation value, increased mild variation rate, and de-creased accelerated area per unit time.
      【Key words】 Non-stress test (NST); The third trimester of pregnancy; Suspicious type; Long-term fetal heart ratemonitoring; Characteristics