二维联合四维超声对产前胎儿畸形的筛查及诊断The Value of Two-dimensional Ultrasound Combined with Four-dimensional Ultrasound in Prenatal Fetal Malformation Screening and Diagnosis
李洪娥,潘锐柯,巴双,于明,张淑琴,支瑞娟
LI Hong'e,PAN Ruike,BA Shuang,YU Ming,ZHANG Shuqin,ZHI Ruijuan
摘要(Abstract):
目的:探讨二维联合四维超声对产前胎儿畸形筛查及诊断价值。方法:选取产前检查疑似妊娠畸形胎儿的800例孕妇,均行二维、四维超声检查,以分娩胎儿结局为标准,分别评价二维超声、四维超声、二维联合四维超声检查方式对畸形胎儿的检出率、敏感性、特异性及准确性。结果:终止妊娠时,有畸形胎儿261例(32.63%),二维超声及四维超声的畸形儿检出率明显低于二维联合四维超声(χ2=7.427,P<0.05),二维联合四维超声诊断的敏感性、特异性及准确性均高于二维超声和四维超声诊断(χ2=8.279、7.464、7.028,P<0.05),二维联合四维超声产前诊断不同类型胎儿畸形的检出率明显高于二维和四维超声(P<0.05)。结论:二维联合四维超声可提高产前胎儿畸形检出率,优于单一的二维超声检查或四维超声检查。
Objective: To study the value of two-dimensional ultrasound combined with four-dimensional ultrasound in prenatal fetal malformation screening and diagnosis Methods: A total of 800 cases of pregnant women with suspected pregnancy malformation were examined by two-dimensional and fourdimensional ultrasound. The detection rate,sensitivity,specificity and accuracy of two-dimensional ultrasound,four-dimensional ultrasound and two-dimensional combined with four-dimensional ultrasound were compared by using fetal outcome as diagnosis standard. Results: There were 261 cases of malformed fetus in termination of pregnancy. The fetal malformation detection rate of two dimensional ultrasound and four dimensional ultrasound was significantly lower than that of two dimensional combined with four dimensional ultrasound( χ2= 7. 427,P < 0. 05). The sensitivity,specificity and accuracy of two-dimensional ultrasound combined with four-dimensional ultrasound were significantly higher than two-dimensional ultrasound and four-dimensional ultrasound( χ2= 8. 279、7. 464、7. 028,P < 0. 05).The detection rate of different type of fetal malformation of two-dimensional ultrasound combined with four-dimensional ultrasound were significantly higher than two-dimensional ultrasound and four-dimensional ultrasound( P < 0. 05). Conclusion: Two dimensional ultrasound combined with four-dimensional ultrasound can improve the detection rate of prenatal fetal malformation,which is better than a single two-dimensional ultrasound examination or four dimensional ultrasound examination.
关键词(KeyWords):
超声检查,多普勒,彩色;超声心动描记术;联合诊断;产前诊断;畸形;价值
ultrasound examination,Doppler,color;echocardiography;echocardiography,four-dimensional;combined diagnosis;prenatal diagnosis;deformity;value
基金项目(Foundation): 连云港市第一人民医院青年英才豪森基金(QN150202)
作者(Author):
李洪娥,潘锐柯,巴双,于明,张淑琴,支瑞娟
LI Hong'e,PAN Ruike,BA Shuang,YU Ming,ZHANG Shuqin,ZHI Ruijuan
DOI: 10.19367/j.cnki.1000-2707.2018.03.018
参考文献(References):
- [1]王允芹,李传红,宋修芹,等.烟台市规范化超声系统筛查胎儿缺陷顺位调查[J].浙江临床医学,2016,18(8):1484-1486.
- [2]李胜利,张葵,田晓先.早孕期胎儿严重畸形的产前超声诊断[J].中华医学超声杂志:电子版,2016,13(2):83-95.
- [3]KHORDADPOOR-DEILAMANI M T,AKBARI.The use of cell-free fetal DNA in maternal plasma for noninvasive prenatal linkage analysis in beta globin gene cluster[J].Bratislavske Leka Rske Listy,2015,116(11):662-665.
- [4]刘湧,王琼,刘艳君,等.超声检查诊断不同孕周胎儿动脉导管内径的临床意义[J].浙江临床医学,2016,18(5):901-902.
- [5]WEN P,XIONG D Y,WANG Y,et al.Reproductive management through integration of PGD and MPS-based noninvasive prenatal screening/diagnosis for a family with GJB2-associated hearing impairment[J].Science China Life Sciences,2015,58(9):829-838.
- [6]钱敏,郑蓉,翟林,等.产前超声筛查先天性心脏缺陷的临床体会[J].中华临床医师杂志:电子版,2016,40(14):2093-2096.
- [7]黄杨,朱小虎,周成香,等.超声软指标在早孕期胎儿心脏结构评估中的价值分析[J].中国医学装备,2016,13(7):57-60.
- [8]严稳开,周静.采用二维、三维超声及连续顺序追踪超声法对胎儿肢体畸形产前超声诊断分析[J].中国医刊,2016,51(3):90-93.
- [9]METTE H,VIUFF K,STOCHHOLM N,et al.Only a minority of sex chromosome abnormalities are detected by a national prenatal screening program for Down syndrome[J].Human reproduction(Oxford,England),2015,30(10):2419-2426.
- [10]徐燕,茹彤,胡娅莉,等.孕中期超声胎儿结构筛查在超声培训中的质量控制[J].现代妇产科进展,2016,25(8):589-592.
- [11]贾素红.超声检查对产前筛查胎儿先天畸形的临床价值[J].贵州医药,2016,40(1):80-81.
- [12]徐庆.产前超声筛查不同孕周胎儿畸形的临床特征分析[J].中国计划生育学杂志,2015,23(10):699-701.
- [13]姚庆荣,杨芃,彭丽珊,等.产前彩色多普勒超声检查对胎儿骶尾部肿块的诊断价值[J].贵州医科大学学报,2017,42(9):1059-1062.
- [14]高原,张玉虹,梁登辉.孕早期产前筛查在染色体异常胎儿诊断中的应用[J].中国生育健康杂志,2015,26(3):240-242.
- [15]陈秀兰,刘桃,袁志燕,等.产前超声四腔心切面显示胎儿食管价值的研究[J].中国临床医学影像杂志,2015,26(9):653-656.
- [16]朱继红.产前超声软指标检查与母体血清学联合检测筛查胎儿染色体异常[J].中国临床医学影像杂志,2016,27(1):38-41.
- [17]刘晓芳,杨昕,张蕊.胎儿脐带囊肿的产前超声诊断及临床结局[J].贵州医科大学学报,2016,41(6):735-737,740.
- [18]张晓磊,黄晓微,熊钰,等.胎儿畸形孕妇终止妊娠的医学和非医学影响因素[J].中华围产医学杂志,2017,20(6):420-426.
- [19]张晓敏,郭小春.彩色多普勒超声在产前胎儿畸形筛查中的应用价值[J].中国现代医学杂志,2017,27(3):112-115.
- [20]张素阁,董磊,王惠,等.超声产前早期诊断联体双胎的价值[J].医学影像学杂志,2017,27(8):1619-1621.
文章评论(Comment):
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- 超声检查,多普勒,彩色
- 超声心动描记术
- 联合诊断
- 产前诊断
- 畸形
- 价值
ultrasound examination,Doppler,color - echocardiography
- echocardiography,four-dimensional
- combined diagnosis
- prenatal diagnosis
- deformity
- value