三维超声诊断胎儿肢体畸形的临床应用.docVIP

三维超声诊断胎儿肢体畸形的临床应用 【摘要】 　　目的 探讨三维超声在产前诊断胎儿肢体畸形中的临床应用价值。方法 对1526例孕妇进行三维超声检查 ，并与引产及生产结果对照 。结果 16例胎儿肢体畸形的孕妇产前三维超声准确诊断14例，诊断不全1例，漏诊1例。本组产前三维超声诊断的准确率为93.75％，漏诊率6.25％。结论 三维超声可以明显提高胎儿肢体畸形产前诊断的准确性，其图像生动逼真，有利于临床医师及患者全面了解胎儿肢体的解剖结构及畸形状况，为临床处置方案的制定提供较为客观的依据。 【关键词】 胎儿畸形 肢体 实时三维 超声 产前诊断 　　The Clinical Application of Three-dimensional Ultrasound in Diagnosing Fetal Limb Deformity 　　Wang Xiaoli, Huang Xiaoyuan, Wei Fang 　　Maternal and Child Hospital of Jiangyang District, Luzhou City, Sichuan Province 646000 　　ABSTRACT Objective To discuss the clinical application of three-dimensional ultrasound in diagnosing fetal limb deformity. Methods 1526 pregnant women received three-dimensional ultrasound examination, and a contrast study was made between the ultrasound examination results and the results of induced labor and delivery. Results Out of 16 pregnant women, 14 cases were diagnosed before delivery by three-dimensional ultrasound to have fetal limb deformity, 1 case was incompletely diagnosed and another 1 case was misdiagnosed; the accuracy rate of three-dimensional ultrasound was 93.75%, the omission diagnostic rate was 6.25%. Conclusions Three-dimensional ultrasound can obviously raise the accuracy rate of the diagnosis of fetal limb deformity before delivery, it can help the doctors and patients have a thorough understanding of the anatomical structure and deformity of the fetus, and it provides objective proof for taking clinical measures. 　　KEYWORDS fetal deformity limb three-dimensional ultrasound prenatal diagnosi 　　胎儿肢体畸形发生率为1/500［1］，是常见的胎儿畸形之一，在产前诊断中主要依靠二维及三维超声，检出率为20％～93.75％，对操作者的临床经验及操作技巧依赖性较高，尤其是肢体远端畸形漏诊率较高。本文旨在探讨三维超声在产前诊断胎儿肢体畸形的临床应用价值。 　　1 资料及方法 　　1.1 一般资料 　　2007年10月～2009 年 3月，来我院检查的14～35周1526 例孕妇，平均年龄（19～40）岁，自愿行二维及动态三维超声检查，发现异常者同意提供生产或引产后结果。 　　1.2 仪器 　　麦迪逊PV-800Live 、频率3.5MHz凸阵探头 ，频率5.0MHz容积探头。 　　1.3 检查方法 　　二维超声按胎儿检查顺序进行扫查，并测量相关数值、存图。沿自然伸直方向追踪显示胎儿四肢，观察其软组织、外形姿势、运动及骨骼结构，骨骼结构包括四肢长骨、关节、手掌、足掌及手足指（趾）。二维超声检查后即进行三维数据采集，选择容积探头对异常肢体采样数次并存储于硬盘中。等待孕妇离开后，进行三维数据分析，回放三维动态