彩色多普勒超声检查对胎儿畸形的诊断价值

The clinical application value of color doppler ultrasound in the fetal malformation screening

目的探讨彩色多普勒超声检查对胎儿畸形的诊断价值。方法收集进行产前检查的孕妇5788例，根据体检情况，筛选具有胎儿先天性畸形高危因素的孕妇1591例作为观察组，无高危因素孕妇4197例作为对照组，进行产前彩色多普勒超声检查，对于发现先天性畸形的胎儿通过引产或分娩后检查来确认产前检查的准确率和漏诊率。结果5788例孕妇中，经过产前彩色多普勒超声检查发现先天性畸形53例，其中唇裂14例、脐膨出2例、脊柱裂并脑积水6例、全前脑1例、内脏外翻4例、小脑蚓部缺失1例、共同房室瓣1例、多囊。肾4例、尿道口膨出1例、法洛四联征1例、输尿管畸形1例、肺囊腺瘤1例、短肢畸形2例、骶膨出2例、无脑儿2例、淋巴管水囊肿4例、脑膨出1例、消化道闭锁1例、膀胱畸形1例、死胎1例、羊膜囊带综合征2例。通过引产后尸检或分娩后新生儿彩色多普勒超声检查，产前彩色多普勒超声检查诊断准确率100．00％。通过引产后尸检、分娩后新生儿彩色多普勒超声检查还发现先天性室间隔缺损1例、房间隔缺损2例，漏诊率5．66％。观察组发生先天性畸形46例，发生率2．89％；对照组发生先天性畸形7例，发生率0．17％；两组胎儿发生先天性畸形发生率差异有统计学意义（X^2=8．12，P〈0．05）。结论产前彩色多普勒超声检查对胎儿先天性畸形诊断的准确率高，是胎儿先天性畸形产前筛查的有效方法。

Objective Objective To study the clinical application value of color doppler ultrasound in the fetal malformation screening. Methods Pregnant women underwent prenatal screening were collected. According to the examination, the pregnant women who had the high risk factors of congenital malformation fetus were selected as the observation group, the normal pregnant women were selected as control group. They all underwent antenatal color doppler ultrasound examination, the prenatal diagnosis accuracy and the missed dignosis rate were confirmed through the induced labor or after delivery inspection. Results After prenatal color doppler ultrasonography, congenital mal-formation found in 53 cases, the diagnostic accuracy rate was 100% , the rate of missed diagnosis was 5.66%. Fetal congenital malformation found in 46 cases in the observation group, which was significantly higher than that in the control group. Conclusion The accuracy of prenatal color doppler ultrasound in the diagnosis of congenital malformation fetus was 100% ,it is an effective method in prenatal screening of fetal congenital malformations.