2020 年第 5 期 第 15 卷

母儿Holter监护与传统多普勒胎心监护在临产后的应用效果比较

Comparison of the mother-fetal Holter monitoring and Doppler electronic fetal monitoring in labor

作者：侯萌;谷晔红

英文作者：Hou Meng Gu Yehong

单位：首都医科大学附属北京同仁医院妇产科100730

英文单位：Department of Obstetrics Beijing Tongren Hospital Capital Medical University Beijing 100730 China

关键词：母儿Holter监护；电子胎心监护

英文关键词：Maternal-fetalHoltermonitoring;Electronicfetalmonitoring

• 摘要：

• 目的 探讨母儿Holter监护与传统多普勒胎心监护在计划阴道分娩孕妇临产后的应用效果。方法 选择2014年10月至2015年5月首都医科大学附属北京同仁医院产科住院计划阴道分娩孕妇120例，应用随机数字表法分为观察组和对照组，各60例。观察组孕妇临产后使用母儿Holter监护仪，对照组使用传统多普勒胎心监护。比较2组阴道分娩者分娩时限和胎心监护活跃期1 h内胎心率曲线累计中断次数、宫缩曲线累计中断次数、异常图形频次以及妊娠结局。结果 观察组中转剖宫产率、产后出血率和新生儿窒息率以及阴道分娩者的分娩时限与对照组比较差异均无统计学意义（均P＞0.05）。观察组胎心监护活跃期1 h内胎心率曲线累计中断次数和宫缩曲线累计中断次数均少于对照组［(12.0±2.2)次比（20.0±2.5）次、(8.0±1.8)次比（21.8±2.0）次］，异常图形多于对照组［(21.0±4.3)次比（18.0±2.9）次］,差异均有统计学意义（均P＜0.05）。结论母儿Holter监护具有临床采集数据精确、降低临床误判率、减少医护人员工作量和孕妇阴道分娩更加舒适的优势，用于临产后阴道分娩孕妇效果优于传统多普勒胎心监护。

• Objective To explore the feasibility and advantages of the mother-fetal Holter monitoring in labor. Methods From October 2014 to May 2015, 120 pregnant women were enrolled in Beijing Tongren Hospital, Capital Medical University. They were randomly divided into Holter group (60 cases) and Doppler group (60 cases). During the labor, mother-fetal Holter monitoring and Doppler electronic fetal monitoring were used accordingly. Between the two groups, the vaginal delivery duration, the pregnancy outcome,the accumulative interruption number of fetal heart rate curve, the accumulative interruption number of uterine contraction curve and the  abnormal pattern frequency were compared. Results There was no significant difference between observation group and control group in delivery time, conversion rate of cesarean section, postpartum hemorrhage rate and neonatal asphyxia rate(P>0.05). During the active period of fetal heart rate monitoring, the cumulative interruptions of fetal heart rate curve and uterine contraction curve in 1 h in observation group were less than those in control group ［(12.0±2.2)times vs (20.0±2.5)times, (8.0±1.8)times vs (21.8±2.0)times］; the frequency of abnormal patterns was statistically higher than that in control group ［(21.0±4.3)times vs (18.0±2.9)times］ (P＜0.05). ConclusionMother-fetal Holter monitoring has the advantage of accurate clinical data collection, and can reduce the rate of clinical misjudgment, reduce the workload of medical staff and provide more comfortable vaginal delivery for pregnant women.Compared with the Doppler electronic fetal monitoring, the mother-fetal Holter monitoring is reliable and accurate.