军队基层医院规范化超声在胎儿超前筛查的临床应用-第三军医大学学报.DOC

军队基层医院规范化中孕期产前超声筛查胎儿异常的临床应用 郭徐林1 权太东1 赵晓月1 张恒1 杨晓星1 何向丽1 王平1 罗新2 解放军第四五八医院 广州 510602 摘要：目的：应用规范化的超声检查程序在中孕早期（11-13＋6W）和中孕中期（18-24W）筛查胎儿宫内异常。方法：2004.01-2008.05对2728例我院就诊的孕妇在中孕期进行有步骤、规范化超声检查：①规范化孕期超声检查时间和次数：11-13＋6W、18-24W；②规范化检查内容：11-13＋6W主要以发现明显畸形和染色体异常的软指标为主，18-24W以筛查胎儿结构畸形为重点；③规范化保存胎儿标准切面图片；④规范化超声报告的内容和格式。结果：规范化超声检查胎儿2728例，发现和产后证实胎儿异常102例（3.7％），其中胎儿及附属物异常48例：前三位病种：头颅畸形10例，不合并其他畸形的胎儿宫内死亡6例，脐带异常6。漏诊6例（占全部检查例数0.22％,占胎儿异常5.9%）.此外软标志阳性54例,其中心腔内强光点48例,除5例晚孕或出生后异常外.90%出生后未见异常.结论：规范化产前超声检查在时间、内容、方法上统一规范，是胎儿孕期检查发现胎儿发育异常和预防出生缺陷的良好有效的手段,本组资料超声诊断胎儿异常的敏感性94.4%,特异性100%。 关键词：规范化 产前超声 出生缺陷 胎儿异常 胎儿畸形 注:1 解放军458医院,2 暨南大学华侨医院 Exploratory development of standardized prenatal diagnosis for fetal abnormality with sonography in military center hospital Guo xulin,Quan taidong,Zhao xiaoyue et al. The 458th hospital of PLA,Guangzhou,510602 Abstract Objective: to detect fetal abnormalities with standardized antenatal sonographic diagnosis for First Trimester(11-13+6W) and Second Trimester (18-24W). Methods: Data were obtained from all 2728 gravidas from gestational weeks 11 to 24 in the period 2004.01-2008.05.They were undergone standardized ultrasonic inspection, measurements of the fetus in the two trimesters with serial assessment of fetal structure and growth:① normalization of inspect time and frequency: First Trimester(11-13+6W) and Second Trimester (18-24W).② normalization of ultrasonic inspection including observation items, ultrasound section. Emphasis on different period is different such as First Trimester is to find fetal soft marker of chromosomal abnormality; Second Trimester is to screen fetal anomaly.③ normalization of imaging picture to be preserved.④ normalization of report format and contents. Results: 102 cases of the 3102 fetuses showed fetal abnormality with standardized antenatal sonographic diagnosis.Of those,there were 48 cases fetal malformation in which most common were nervous system, dead fetus，adjuncts of placenta and umbilical core. Conclusio