探讨胎心监护无负荷试验(nonstress test，NST)中变异减速(variable deceleration,VD)发生的影响因素及围生儿结局。

回顾性分析2 160例胎儿监护NST中，141例出现VD患者的胎心心率监护图形，比较不同图形影响因素的发生率和围生儿结局。

胎心监护NST中，VD的发生率为6. 5% (141/2 160)。141例出现VD患者中，单纯VD为77例(单纯VD组)，不典型VD为64例(不典型VD组)。单纯VD组中，影响因素发生率为55. 84%(43/77);不典型VD组中，影响因素发生率为95. 31%(61/64)，两组比较，差异有显著意义(P<0. 001)。VD患者分娩的141例新生儿中，1 min Apgar评分大于7分的为125例，小于7分的为16例。其中，单纯VD组新生儿窒息率为2. 59%(2/77)，而不典型VD组新生儿窒息率为21. 21%(14/66)，两组比较，差异有显著意义(P<0. 001)。单纯VD组剖宫产率(20. 78%)低于不典型VD组(54. 69%)，两组比较，差异有显著意义(P<0. 001)。

胎心监护NST中，VD的发生与多种因素有关，其中脐带异常最常见。胎儿窘迫导致的不典型VD较单纯VD更容易发生。

To investigate the influential factor and corresponding neonatal outcome of variable deceleration (VD) that exist in fetal heart rate(FHR) pattern of nonstress testing (NST).

A retrospective review of 141 FHR patterns with VD in whole 2 160 NST records was performed to compare the incidence of the influential factor and the outcome of neonatus between different VD patterns.

The incidence of VD was 6. 5%(141/2 160)in NST. The rate of influential factor appeared in simple VD and atypical VD was 55. 84% (43/77) and 92. 42% (61/64) respectively, the difference have statistical significance(P<0. 001). Among 141 neonatus,125 cases had Apgar scores that higher than 7 at1 minute, 16 cases had that scores lower than 7. Neonatal asphyxia rate was 2. 59%(2/77)in cases with simple VD, was 21. 21 % (14/66) in cases with atypical VD, and the former ones had a lower cesarean section rate than the later ones (20. 78% vs. 55. 05%, P<0. 001).

VD which exist in NST is correlated with many factors, of the total umbilical cord abnormality is most common. Fetal distress induce atypical VD more easier than simple VD.