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中华医学超声杂志（电子版）

中华医学超声杂志（电子版） ›› 2017, Vol. 14 ›› Issue (11) : 862 -865. doi: 10.3877/cma.j.issn.1672-6448.2017.11.013

所属专题： 妇产科超声影像学； 文献； 妇产科超声；

妇产科超声影像学

产时超声的临床应用研究
赵巧梅1, 邓学东2,†(), 殷林亮2, 赵静2, 林文志2   
  1. 1. 215002　南京医科大学附属苏州医院　苏州市立医院超声中心；223002　江苏省淮安市妇幼保健院超声科（现在江苏省淮安市妇幼保健院工作）
    2. 215002　南京医科大学附属苏州医院　苏州市立医院超声中心
  • 收稿日期:2017-09-25 出版日期:2017-11-01
  • 通信作者: 邓学东

A study on clinical application of intrapartum ultrasound

Qiaomei Zhao1, Xuedong Deng2,†(), Linliang Yin2, Jing Zhao2, Wenzhi Lin2   

  1. 1. Center for medical ultrasound, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou 215002, China; Department of ultrasound, Huai′an Maternity and Children Hospital, Huai′an 223002, China
    2. Center for medical ultrasound, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou 215002, China
  • Received:2017-09-25 Published:2017-11-01
  • Corresponding author: Xuedong Deng
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赵巧梅, 邓学东, 殷林亮, 赵静, 林文志. 产时超声的临床应用研究[J]. 中华医学超声杂志（电子版）, 2017, 14(11): 862-865.

Qiaomei Zhao, Xuedong Deng, Linliang Yin, Jing Zhao, Wenzhi Lin. A study on clinical application of intrapartum ultrasound[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2017, 14(11): 862-865.

目的

应用产时超声获得与产程图相对应的超声图像进行临床应用研究。

方法

选取2017年4—6月于淮安市妇幼保健院行阴道试产的产妇123例，产程中每两小时对产妇行一次二维超声检查。应用经腹部或会阴部二维超声横切面扫查获得与胎方位相关的图像，判断胎方位；经会阴部矢状切面及横切面扫查获得与胎头下降位置相关的图像，即测量产程进展度数（AOP）及胎头与会阴距离（HPD）的图像，判断胎头下降位置；经会阴部横切面扫查获得与宫口扩张大小相关的图像，测量宫口扩张前后径，判断宫口扩张大小。

结果

123例产妇均获得与判断胎方位相关的产时超声图像、与胎头下降位置相关的HPD测量图像和122例AOP测量图像；并获得121例测量宫口扩张大小的图像；所获超声图像均能清晰呈现出各种产时超声标记用于判断胎方位、胎头下降位置、宫口扩张大小。

结论

产时超声可以获得产程图相关的超声图像，用于临床监测产程的研究。

关键词: 超声检查，产时, 胎方位, 产程进展度数, 胎头与会阴距离, 宫口扩张
Objective

To discuss the clinical application of getting the images related to the partogram content using the intrapartum ultrasound.

Methods

One hundred twenty-three pregnant women who tried vaginal delivery in Huai′an Maternity and Children Hospital were included in this study. Intrapartum ultrasound was performed during the progression of labor every two hours. To obtain the images related to the fetal position by transabdominal or transperineal ultrasound in transverse view, determining the fetal head position; to obtain the images related to the fetal head station by transperineal ultrasound in mid-sagittal and transverse views , measuring the angle of progression (AOP) and the fetal head-perineum distance (HPD); to obtain the images related to the cervical dilatation by transperineal ultrasound in transverse view, measuring the anteroposterior diameter of the cervical dilatation.

Results

This study included 123 pregnant women, 123 images were obtained related to the fetal position; 122 images of AOP related to the fetal head station were measured; and 123 images of HPD related to the fetal head station were measured; 121 images related to the cervical dilatation, all the images can clearly displayed various ultrasonic markers, which can be used to determine the fetal position, the fetal head station and the cervical dilation.

Conclusion

Intrapartum ultrasound could get the images related to the partogram content, it could be studied to use in labor.

Key words: Ultrasonography, intrapartum, Fetal position, Angle of progression, Head-perineum distance, Cervical dilatation
图1~3 自然临产进入产程的产妇产时超声获得与判断胎方位相关声像图。图1为枕前位声像图（红色箭头示小脑，绿色箭头示脑中线）；图2为枕横位声像图（红色箭头示小脑，绿色箭头示脑中线）；图3为枕后位声像图（蓝色箭头示眼眶）
图7~9 自然临产进入产程的产妇产时超声检查获得判断胎头下降位置与会阴距离测量图像（虚线示胎头与会阴距离）。图7为产时胎头下降位置与会阴距离3.0 cm时图像（黄色箭头示会阴，紫色箭头示胎头）；图8为产时胎头下降位置与会阴距离5.0 cm时图像（黄色箭头示会阴，紫色箭头示胎头）；图9为胎头下降位置与会阴距离8.0 cm时图像（黄色箭头示会阴，紫色箭头示胎头；距离不同表示胎头下降位置不同）
表1 123例产妇超声监测产程进展度数，胎头与会阴距离及宫口扩张大小测值（cm，例数）
检测参数 例数 极小值 极大值 均值 标准差
产程进展度数（°） 123 84° 165° 112.84° 15.05°
胎头与会阴距离（cm） 123 2.8 8.1 5.84 1.14
宫口扩张大小（cm） 121 3 10 6.06 1.86
图10~12 自然临产进入产程的产妇产时超声检查获得宫口扩张大小测量图（虚线示宫口扩张大小前后径）。图10为产时产妇宫口扩张3.0 cm时图像（红色箭头示宫颈）；图11为产时产妇宫口扩张6.6 cm时图像（红色箭头示宫颈）；图12 为产时产妇宫口扩张9.5 cm时图像（红色箭头示宫颈，绿色箭头示胎头）
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