胎儿尸体高频超声检查替代尸检方法的可行性研究

Study on the feasibility of high-frequency ultrasound examination of fetal corpse to replace autopsy

目的对比研究胎儿尸体高频超声检查与胎儿尸检结果,探寻胎儿尸体高频超声检查替代尸检方法的可行性。方法对引产后30例异常胎儿尸体进行全身高频超声检查,对异常器官或结构进行多切面、多角度扫查,将高频超声检查结果与尸检结果进行对比。结果30例异常胎儿,尸检共检出结构畸形49处,高频超声检出结构畸形43处,高频超声检查结果与尸检结果符合率为87.7%（43/49）。在49个结构畸形中,有5个心脏结构畸形,只有2个与尸检符合,心脏结构畸形符合率较低,如果把心脏结构畸形除外,则胎儿尸体高频超声检查与尸检结果符合率可提高到95.3%（41/43）。结论虽然尸检是评估胎儿异常的最佳选择,但是在尸检被拒绝时,胎儿产后高频超声检查是有效可行的替代尸检方法。

Objective To investigate the feasibility of the high-frequency ultrasound examination of fetal corpse to replace autopsy.Methods The bodies of 30 cases of fetal corpse induced labor for abnormality were examined by using high-frequency ultrasound.Multiple angle and multiple section scans had been done for abnormal organs and structure.The results of high-frequency ultrasound of fetal corpse and that of the autopsy findings were study comparatively.Results Among the 30 cases of abnormal fetus,49 structure abnormalities were found by autopsy and 43 structure abnormalities were found by high-frequency ultrasound.The coincidence was 87.7%（43/49）.In the 49 structure abnormalities,5 cases were cardiac abnormality and only 2 were diagnosed by ultrasound.The coincidence was 95.3%（41/43）excluding this 2 cases.Conclusions Autopsy was the best way for evaluating the cause for the death fetus.When the autopsy were refused,the high-frequency ultrasound was an effective way to replace autopsy and could be a best alternative.