B超在胎儿产前畸形诊断中的应用效果与诊断策略分析.docVIP

B超在胎儿产前畸形诊断中的应用效果与诊断策略分析 张庆辉 广州军区武汉总医院南湖妇产中心B超室 X 关注成功！ 加关注后您将方便地在 我的关注中得到本文献的被引频次变化的通知！ 新浪微博 腾讯微博 人人网 开心网 豆瓣网 网易微博 摘????要： 目的 探究B超在胎儿产前畸形筛查中的重要作用及临床确诊技巧、策略和方法。方法 比较在本院分娩及产前畸形检查的一般及需重点筛查对象的胎儿畸形发病率、B超确诊率及其与致畸因素之间的相关性及差异, 总结B超在胎儿产前诊断的技巧与规律。结果 重点筛查对象畸形胎儿发病率达14.33%, B超确诊率严重畸形、小畸形分别为95.59%、29.63%, 明显高于一般筛查对象。结论 以孕早期、中期、后期4次B超检查及多人会商确诊模式, 以及熟练的胎儿畸形诊断知识及技能可以有效提高B超确诊率。 关键词： 产前诊断; 先天畸形; 超声检查; 收稿日期：2017-06-08 Application effects and clinical tatics of B-ultrasound in the screening of fetal anomaly Zhang Qinghui B-Ultrasonic Room of South Central Obstetrics and Gynecology Center, Wuhan General Hospital of Guangzhou Military Region; Abstract： Objective To investigate the important effect and clinical application of B-ultrasound in the screening of fetal anomaly. Methods The rate of fetal abnormality, the accuracy rates of B ultrasound and the correlation between the rates and teratogenic factors were compared from general and key screening delivery and newborns in our hospital. Furthermore, the technique and rules of B-ultrasound in the prenatal diagnosis was sum up. Results The rate of fetal abnormality of key screening newborns was 14.33%, and the accuracy rates of B ultrasound for the severely malformation and minor malformation was 95.59% and 29.63%, respectively, which was higher than those general screening newborns. Conclusion Screening of early, middle, late, 4 times B ultrasound examination and the multiple consultation model, as well as skilled fetal malformation diagnosis knowledge and skills, could effectively im-prove the diagnostic rate of B ultrasound. Keyword： Prenatal diagnosis; Congenital abnormality; Ultrosonography; Received： 2017-06-08 目前我国新生儿出生缺陷总发病率高达4%~6%, 并有逐年增高之势[1]。其中, 无脑儿、脑积水、开放性脊柱裂、脑脊膜膨出、唇腭裂、先天性心脏病等先天畸形是新生儿常见缺陷[2]。先天畸形等出生缺陷不仅严重危害新生儿童的生存和生活质量、影响家庭幸福, 也已成为全面提高人口质量和素质的重要障碍。开展产前筛查是预防和减少新生儿出生缺陷的最主要手段[3]。B超因可实时、多角度、全面显示胎儿各部位各器官的直观图像, 且对胎儿及孕妇安全无损伤、操作简单、畸形检出率高等优势, 已被公认为胎儿畸形诊断中首选和必不可少的方法, 并已成为超声医师必须掌握的最重要的基本技能之一[4]。然而由于胎儿在宫腔中的体位以及仪器设备等局限的原因