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題名 | The Use of Amniotic Fluid Shake Tests, L/S Ratio and Creatinine Concentration in the Evaluation of Fetal Maturity and Risk of Neonatal Respiratory Distress Syndrome=羊水泡沬試驗L/S 比率及肌酸酑濃度對胎兒成熟度及預估新生兒呼吸窘迫症發生之評估 |
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作者 | 曹龍彥; | 書刊名 | 中華民國小兒科醫學會雜誌 |
卷期 | 26:5 民74.09-10 |
頁次 | 頁411-419 |
分類號 | 417.145 |
關鍵詞 | 比率; 成熟; 羊水; 肌酸酑; 呼吸; 泡沬; 胎兒; 發生; 窘迫症; 評估; 新生兒; 試驗; 預估; 濃度; |
語文 | 英文(English) |
中文摘要 | 從民國71年1月至民國73年12月,在本院經由羊水穿刺術收集了65例孕婦的羊水做試驗,以羊水泡沫試驗,改良的泡沫試驗,L/S比率及肌酸酐濃度對胎兒及胎兒肺成熟度之評估,其結果如下:(1)羊水之泡沫試驗,改良的泡沫試驗,L/S比率及肌酸酐濃度等方法與胎兒成熟度呈甚佳之直線相互關係,其相關係數(γ值)分別是0.510, 0.443, 0.703, 0.617。(2)羊水之泡沫試驗法(<2+對≥2+),改良的泡沫試驗法(<2+對≥2+),L/S比率(<2.0對≥2.0),肌酸酐濃度(<1.5mg/100ml對≥1.5mg/100ml),在預估新生兒呼吸窘迫症之發生,在統計學上呈有意義之差異,其P值皆<0.001。(3)在此數種檢驗法中,單一試驗之羊水泡沫法為最佳(92.3%),所有之檢驗法在預估胎兒之成熟度比預估胎兒之不成熟度更為準確。(4)羊水泡沫試驗法或羊水肌酸酐濃度與羊水L/S比率亦呈頗佳之直線相互關係(其γ值=0.32~0.5)。本研究顯示:羊水之泡沫試驗,改良的泡沫試驗,L/S比率及肌酸酐濃度等方法在預測胎兒成熟度及新生兒呼吸窘迫症之發生,甚具臨床價值,其中快速簡便的檢驗法如:羊水泡沫法,羊水肌酸酐濃度法更可廣泛地運用在緊急狀況及沒有L/S比率則定設備之醫院。 |
英文摘要 | A total of 65 shake tests (Clements and FS-50 tests), 65 L/S ratio, 58 creatinine concentrations were carried out on amniotic fluid specimens. The results were analyzed in relation to gestational age and neonatal respiratory distress syndrome. This study revealed that: (1) Clements tests, FS-50 test, L/S ratio, and creatinine concentration vs. gestational age showed a good positive linear relationship, with correlation coefficients of 0.510, 0.443, 0.703, 0.617, respectively. (2) Clements tests (<2+vs.≥2+), FS-50 test (<2 vs. ≥2+), L/S ratio (<2.0 vs. ≥2+), creatinine concentration (<1.5mg! 100 ml vs. ≥1.5 mg/100 ml) showed statistically significant differences in occurrence of neonatal respiratory distress syndrome with P value < 0.001. (3) The sensitivity, specificity, predictive value positive, predictive value negative of these tests and their combinations were also calculated. All of these amniotic fluid indices of fetal maturity were better predictors of maturity than of immaturity. (4) Statistical relationships of shake tests vs. L/S ratio and amniotic fluid creatinine concentration vs. L/S ratio showed fair to good correlation, it was concluded that amniotic fluid analysis with shake tests, L/S ratio, and creatinine concentration are valuable in assessing fetal maturity and in predicting the likelihood of neonatal RDS. The rapid tests (shake tests and creatinine concentration) can be widely used in emergency situations or in those hospitals where L/S ratio and phosphatidylglycerol, phosphatidylinositol determinations are not available. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。