Doppler ezingekazalwa: ukusebenza kunye kokuhlaziya

Namhlanje kwi lokufunyaniswa malformations foetal kunye ukugeleza ukuphazamiseka ukhulelwe ngakumbi usebenzisa izixhobo zale mihla ekuvumela ukuba ukujonga ingxaki evela ngaphakathi. izixhobo cuke isetyenziswa ngokubanzi uxilongo kunye nohlalutyo izifo kunye nemiqathango emzimbeni womntu. Ezo zifundo nime kulo mkhuba zonyango phantse sele inkqubo lokuqaphela nonyango. Kuba abafazi abakhulelweyo, ukongeza izifundo rhoqo amisele ultrasound ezingekazalwa kunye Doppler velocimetry. Kuyinto eqhelekileyo ukuba naliphi na iziko lonyango.

Doppler

Kulo lonke ixesha sokukhulelwa baby machine mfazi elimisiweyo isifundo ultrasound. Kumanqanaba ahlukeneyo zokukhulelwa, Doppler ezingekazalwa wabelwa ukuba uphando kunye nokuthintelwa ukuphazamiseka yophuhliso. Doppler - ultrasound yenye iintlobo, nkqubo leyo idla ngokwenziwa kwezi nyanga zokugqibela zokumitha, ngokuqhelekileyo kwithuba leenyanga ezintathu lesithathu.

ISifundo negazi kwemithambo umbungu engundoqo, isibeleko, ngumkhaya ukuvavanya igazi flow Velocity kunye nemeko iimpahla ezinkulu imithambo enkabeni, ukubonelela ngenkxaso kunye nezondlo engekazalwa. Ukwenza isifundo esinjalo kufuna umlomo okhethekileyo. Ngokuqhelekileyo, Doppler ultrasound lwenziwa kunye engundoqo okanye kubhalwa njenge eyahlukileyo, ugqirha ezongezelelweyo izifundo.

Ukuqeshwa ultrasound ne Doppler

Doppler ukujonga ubungakanani ngqo, le ubukhulu kunye nendawo kwemithambo eziphambili, iziqhamo kuphela, kodwa ngumkhaya, imfesane yosana, esizalweni yomfazi, ukuhamba kwegazi Velocity nasezimpahleni, kananjalo kwenza kunokwenzeka ubhaqo ngexesha lobukho naziphi izitenxo okanye umsebenzi eziphilayo ngumkhaya, nto leyo inokuba intwasahlobo iingxaki ezahlukeneyo apha ngethuba lokukhulelwa ngexesha zabasebenzi. Ngako oko, ukubaluleka phando kufanele kungajongelwa phantsi. Ngenxa yoko, Doppler ngexesha eqinisekiswe ezingekazalwa yemida yayo kuvumela ixesha lokwenza lulondolozo lokuthintela, lula imeko kunye nokuthintela imingcipheko kunokwenzeka.

Ubungqina obubonakalayo buxela ukuba Doppler

Doppler njengoko uphando olongezelelweyo kufuneka ukuba amisele, umfazi omithiyo xa kufunyenwe ezi zifo zilandelayo:

• Yokukhulelwa.
• isifo sentliziyo unesifo.
• isifo sezintso.
• Diabetes osegazini.

Kwakhona Doppler Ingane linokukwenziwa kwi ekufumanekeni ukuphazamiseka yophuhliso, bekhubazekile, ukulibaziseka yophuhliso, oligohydramnios, ithuba nokwanda ngaphambi ngumkhaya, ukungaqheleki imfesane yosana kubume okanye abanala makhwiniba chromosomal enaso, iintlobo kakhulu sisifo sentliziyo, njalo njalo ekuqaleni. D.

Uphononongo lwe zesibeleko indlela kwemithambo Doppler

Doppler Ukufunda zesibeleko Umthambo ukuvavanya imeko olujikeleza ye isibeleko, ngumkhaya, isithuba mezhresnichnogo. isithuba Formation mezhresnichnogo kwenzeka kude ngexesha umzila umbungu, malunga neveki emva kokukhulelwa. Blood kwegazi wesibeleko eli bhinqa lwenziwa inxaxheba kwemithambo ezimbini: ovarian kunye zesibeleko. Nokuba ngexesha lokusekwa ngumkhaya ezindongeni kwemithambo, ezinye iinguqulelo kwenzeka, nto leyo ekugqibeleni kukhokelela ekukhuleni kwabo kunye nokwandiswa ngaxeshanye kunye ekukhuleni ngumkhaya. Ngokusebenzisa le nkqubo, ukuhamba kwegazi uteroplacental ukhandwa ukugqiba ukusekwa ngumkhaya nokwanda izihlandlo ezili-10.

Wesizalo Umthambo Doppler ivumela ukuvavanya ukusebenza isantya kwemithambo ukwakhiwa leyo iphela encotsheni senyanga-3. Ukuba ngexesha lokukhulelwa kuvela iingxaki akuthethi kuthi kulo lonke imithambo utshintsho ukusebenza komzimba; ngoko ke musa ukwandisa kwaye sikhule ngexesha ukukhula ngumkhaya. Ngaloo ndlela imithambo kuba abakwazi ukuqinisekisa ngokwaneleyo ukujikeleza kwegazi ukuya ngumkhaya, nto leyo enokukhokelela ekubeni ukufa okanye ukuswela izondlo, ioksijini. Oku, kungakhokelela ekubeni kwecala ngumkhaya, kwesisu kunye kwezisu.

Doppler: yombhalo

Ngexesha isifundo Doppler kwifowuni ultrasound screen ibonisa lumelo olubonakalayo lwe ukuhamba kwegazi Velocity kwi imithambo ngethuba ngamnye mjikelo kwentliziyo, ezahluke ngayo iSystolic kunye ukuzala. Ukuze siyiqonde kwixesha elizayo, yintoni na busengozini, wenze yombhalo:

• Systole - uxinzelelo ngenxa kunciphiso izihlunu zentliziyo.
• Diastole - nto kufunwa eyenziwe ngexesha ukucuthwa imisipha yenhliziyo.

Ngoko ke, intliziyo omnye bamtyabula ufundo bavela iSystolic kwaye iDiastolic wegazi yegazi. Kuba ngasinye izitya yokuhlolwa inemigaqo yayo kunye neempawu igazi eqhelekileyo flow Velocity amagophe.

Ukuvavanya imigangatho kunye nezalathisi yegazi wasebenzisa indices zilandelayo:

• ISystolic-ukuzala ratio.
• index Pulse.
• index ukumelana.

ISystolic-ukuzala ratio, isalathisi ukubetha kwentliziyo kunye nesalathisi ukumelana zibonisa imeko kwemithambo eziphambili kunye aorta negazi lokuhamba kwabo, nto leyo ke injongo yolu phando, njengoko Doppler. Norms and ezinxaxhileyo kubo ezibonisa iintlobo ezahlukeneyo kwephulwa Palsy, ungachaza ngezifo ezinxulumene kunye nefuthe yokumpompoza kwegazi uthela umntwana. Ngoko ke, ugqirha nga ukuvavanya ukusebenza ngumkhaya kunye nokubanakho, yesixa oksijini kosana olungekazalwa ngenxa imfesane yosana, kwakunye neziphene kunokwenzeka Palsy ezinxulumene nokuphazamiseka yegazi kunye nezifo ze imisipha yenhliziyo.

Doppler: imithetho

Ukuvavanya iziphumo zezifundo Doppler wasebenzisa kwitafile ekhethekileyo lwamaxabiso. Baya ukucacisa yonke nemigangatho eyamkelekileyo Doppler Fetal beempawu ezintathu:

• ISystolic-ukuzala ratio.
• index ukumelana.
• index Pulse.

Izifundo ezo kufuneka kwenziwe bonke abasetyhini abakhulelweyo, kodwa kubalulekile ngokukodwa ukuba nabani na emngciphekweni kwaye iingxaki kunye nokuhamba kwegazi, okanye iziphene njengelifa.

Doppler ukufunda ultrasound ezingekazalwa kunye nemithambo utyunjelwa ithuba leeveki-23 zokukhulelwa. Ngeli xesha, inkqubo leyo efanelekileyo kakhulu iqela yovavanyo umngcipheko iingxaki kunye malformations placental, nto leyo enokukhokelela ukupheliswa lokukhulelwa. Kodwa izifundo ezinjalo yenziwe ukususela kwiiveki-13 ukuya ekupheleni yokukhulelwa. Veki nganye indices yayo Doppler lakhe. Zonke ezi zifundo zenziwa ukuze bahlole imithambo ezintathu eziphambili: Umthambo yosana, zesibeleko, aorta Palsy.

Isalathisi iSystolic-ukuzala ratio, ukususela kwiiveki ezingama-20 zokukhulelwa, kufuneka 2.4 okanye ngaphantsi.

Isalathisi uxhathiso ibalwa ngenxa kwemithambo yosana, zesibeleko, kunye MCA. Ummiselo ngu:

• ngokuba unina - ngaphantsi kune okanye ilingana 0,58;
• ngokuba Umthambo yosana - incinane kune okanye ilingana 0.62;
• index kufuneka ibe ngaphantsi kwe okanye ilingana 0,77 kwemithambo ophakathi ayingxenye umntwana.

Kuba Kwisiqingatha sesibini lokukhulelwa, la manani phantse ingatshintshanga. Kwaye ekupheleni kwexesha kwezalathisi lokumitha iSystolic-ukuzala ratio mayingagqithi iiyunithi ezimbini.

Ibonisa amanani

Doppler 3 ezintathu izifundo igazi foetal kwemali kwaye kunegalelo uxilongo ekuqaleni, injongo nothintelo insufficiency placental, unyango yokukhulelwa kunye notshintsho uphawu yokumpompoza kwegazi kwimikhumbi zesibeleko. Ekuchongeni ukuhla amaxabiso kuthetha ukuzala, iSystolic-ukuzala ratio kakuhle kakhulu, kwaye ngokufanelekileyo, omnye isalathiso, ibalwe ngenxa yalo, kananjalo kuyanda.

Xa Doppler kwi zesimesta yesibini neyesithathu zokukhulelwa ingqalelo eyodwa ihlawulwe ziingcali umthambo yosana. Kwigophe yokufunda kwemithambo usembindini igazi imfesane yosana ithatha ezibalulekileyo emva kwiveki yeshumi yokukhulelwa. Kule nkalo yokumpompoza kwegazi ukuzala ayikwazi ukubonwa malunga neeveki ezili-14. In foetal chromosomal ukungaqheleki eye uphawu kwiiveki 10-13 sokukhulelwa kubhalwa ngokuqhelekileyo flow ukuzala umva.

Xa lokukhulelwa iSystolic-ukuzala ratio gingxi ayidluli iiyunithi ezintathu kwigophe ukubonisa egazini. Kuba zoxilongo Palsy luphawulwa sehla kuphelisa uqina ukuzala de zanyamalala epheleleyo.

Yi ngenyanga yesihlanu lokukhulelwa phambili zalathisi sokuxilonga abe uphando isiqhamo yokumpompoza kwegazi. Uphonononga wamaziko aorta kunye kwemithambo eliphakathi lobuchopho. Iinqobo zezi kwemali egazini kuye imigubasi yomnyango omkhulu utshintsho uxinzelelo iSystolic kwi aorta, ngokufuthi sikhatshwe ukuncipha yokusebenza ukuzala. I ezincinane bona, kungona umngcipheko ezimbi. Imeko ezingaginyisi is a zero ixabiso ingxenye ukuzala.

Kuba utshintsho ephakathi palsy kwimithambo kwezonyango flow igazi ikhatshwe, phezu koko, ukwanda icandelo ukuzala, mvisiswano leyo, kwelinye icala, i sisibonakaliso hyperperfusion yobuchopho kwaye ibonisa uphuhliso hypoxia Palsy.

Xa isifundo wegazi flow kule ntaba lwemithambo duct iSystolic uphethe uninzi kummandla umdla kwigophe kwaye egungxulwayo ngaphandle utshintsho ngokukhawuleza umana usithi nkxu kuvela icandelo ukuzala ixesha elifutshane. Ngoko ke, yonke kwigophe le kakhulu uniform ngaphandle iincopho ezibukhali zanikezelwa. Ukuba luchazwa iincopho ephakamileyo candelo iSystolic, okanye yokuduka xi ukuzala, oko kusenokubonisa ukuba kukho chromosomal ngezifo ezingekazalwa, kwakunye kukuvela hypoxia Palsy.

Ukuchaneka Indlela ultrasound Doppler imalunga-70%. Ngempumelelo kakhulu ukufunda Esibelekweni-placental kunye ithombo legazi ezingekazalwa-placental, eseyiphantse likhulu ekhulwini unako nokuxilonga zezigulo ezahlukeneyo.

Ukuhlolwa kweziphumo zokufunda

Ngokutsho indices ezahlukeneyo negazi neziphawuli yahlulwe izidanga ezahlukeneyo:

• 1 degree - le isiphazamiso flow kwegazi uteroplacental igazi iziqhamo placental rhoqo okanye ukuhlukunyezwa iziqhamo placental kunye uteroplacental unmodified.
• 2 degree - oko ngexesha elinye-utshintsho ukuphazamiseka zombini iindidi lokumpompoza igazi, neziphawuli musa ukufikelela naziphi na izinto ezibalulekileyo, kodwa kufuneka indawo ukuba.
• Grade 3 - bubukho zokuphula ezibalulekileyo ngokwemigaqo yokumpompoza kwegazi iziqhamo-placental, kungakhathaliseki nokuba utshintsho okanye ukunyhashwa nokuba amancinci Esibelekweni-placental flow kwegazi.

Ubungqina obubonakalayo buxela ukuba Doppler yokuqeshwa

Doppler Fetal nga kulawulwa kanye okanye kabini ngexesha esakhulelwe njengoko inkqubo lwesiqhelo. Maxa wambi emiselweyo rhoqo. Oku kwenzeka xa kukho ubungozi okanye ezimbi yosana olungekazalwa okanye imeko elifunekayo wesibeleko kunye ngumkhaya. Kukho uluhlu lwe ezibonisa sifuna nje ukuba izifundo flow qiniseka and Doppler:

• Ukuba ubudala sikanina yiminyaka abangaphezu kwama-35 okanye ngaphantsi kwama-20 (kusasa okanye ukukhulelwa emva kwexesha).
• Polyhydramnios kunye oligohydramnios.
• On ukufunda wavelisa umatshini ultrasound ngaphambili kutyhilwa intambo singabanjwa.
• Uphuhliso Fetal libe lisalele ngasemva ngokwemigangatho emiselweyo.
• Unina waphawula sifo kakhulu esingapheliyo.
• Xa nokukhulelwa sangaphambili siphele khona kwesisu okanye abantwana bazalwa kunye ukukhubazeka ezinzima okanye eswelekile.
• Ukuba kukho ukuba ukusola malformations.
• Xa ukhulelwe.
• Ukuba umama a negative RH into, nto leyo nesiphumo ukwaliwa Umbungu kunye kwegazi.
• Xa iparameters kwinzuzo CTG.
• Ukuba indawo abe umothuko abakhulelweyo esiswini.

Ukuba kukho isoyikiso kukho uphazamiseko ngesiquphe ukukhulelwa, qiniseka ukuba izifundo ukuqeshwa Doppler ukuba oonobangela olo loyiko. Kulo mzekelo, lo mfazi ulele esibhedlele ngemini, apho ityala lokuqala ekubeni kuvavanywa ultrasound Doppler kwaye ufumana nonyango hormone ukwenzela ukugcina ukukhulelwa ukuya kwelide, ukuze apho kunokwenzeka khona ukuba aqhube unikezelo ekhuselekileyo kunye ingozi encinci.

Survey Ukulungiselela

Ukulungiselela izifundo Doppler in ezinqwenelekayo ukhulelwa ezimbalwa kwiiyure phambi utyelelo ofisi US ukuba nidle ukudla uze emanzini kujphela. Ukuqala isifundo kufuneka kulala esofeni ecaleni umatshini emhlana walo, ebonisa ngexesha elifanayo esiswini ukususela esifubeni ukuya ubudoda. Kumphezulu esisu okhulelwe isicelo enye okanye ngaphezulu amathontsi ye ijeli ekhethekileyo conductive kunceda kwii-uphawu cuke yaye kongezwe kulo sensor ezizodwa, ezikhokelela ngokumpuluswa kumphezulu esiswini.

Doppler Fetal enokwenziwa ibe izinxibo emnyama namhlophe, kunye nombala ngoku apho ultrasound aya kubona amagophe encopho ezibonisa amandla kunye nezinga zokutenxa kuyo okanye flow igazi imithambo. Emva uviwo, ugqirha uza kuzisa i data efunyenwe ngethuba loviwo, uze ubhale ukuba okotshiweyo, yaye ke uya kube sekuphelisweni Doppler ultrasound kwizandla umfazi omithiyo.

Doppler izalathisi Palsy nentsingiselo yabo iya kuba luncedo esihle obstetrician-ugqirha kulawulo abasetyhini abakhulelweyo belungiselela ekhuselekileyo ukunikezelwa kunye nolawulo iingxaki. Ukubeka iliso amalungu angaphakathi Umbungu ngokusebenzisa izifundo Doppler kuba lula kakhulu kwaye sele iminyaka emininzi bubungqina ukusebenza kunye nokuthembeka. Liyanda inani lezifundo olwenziwe kwiminyaka yakutshanje, ukuxhasa uhlolo lokhuseleko kunye nobugcisa ultrasound, ukuphelisa ithuba nobungozi kwimpilo bobabini umama okhulelweyo kunye nosana olungekazalwa.