超声胎儿颈项透明层联合鼻骨测量在染色体异常诊断中的应用研究

Applied research of the ultrasound fetal neck transparent layer joint nasal bone measurement in the diagnosis of chromosomal abnormalities

目的 讨论联合胎儿颈项透明层检测和鼻骨测量在染色体异常诊断中的应用价值.方法 在四平市第一人民医院检查的高危妊娠人群中,选择35例作为研究对象,记录观察组产前筛查过程中患儿的颈后透明层（NT）厚度和胎儿鼻骨（NB）的长度情况,记录NT在诊断胎儿畸形中的应用价值;同时观察胎儿鼻骨的发育状态,对胎儿进行全面检查,记录观察组胎儿先天畸形情况,应用SPSS 17.0统计学软件对结果进行统计学分析处理.结果观察组患儿颈后透明层厚度与对照组相比,在11～11＋6（t6.625,P=0.023）、12～12＋6（t=6.358,P=0.019）、13～13＋6（t=5.254,P=0.004）孕龄相比,差异有统计学意义.胎儿鼻骨长度与孕龄呈直线线性相关（r=0.801,P=0.038）.21例在颜面正中矢状切面上未见连续性鼻骨超声图像,19例诊断鼻骨缺失,5例诊断为发育不良.结论 通过在产前积极开展超声胎儿颈项透明层联合鼻骨测量,在染色体异常诊断中具有极高的应用价值,能有效提高染色体异常的诊断率.

Objective To discuss the applied value of the ultrasound fetal neck transparent layer joint nasal bone measurement in the diagnosis of chromosomal abnormalities.Methods 35 cases of high-risk pregnancies in the First People＇s Hospital of Siping City were selected as research object,back of the neck transparent layer （NT） thickness and length of the fetal nasal bone （NB） of children in prenatal screening process in control group,the application value of NT in the diagnosis of fetal malformations was recorded; while the development of the fetal nasal bone status was observed,the fetus was conducted comprehensive examination,and fetal congenital malformation of the observation group was recorded.The results were statistically analyzed by SPSS 17.0 statistical software.Results There were statistically significant differences in 11-11＋6 （t =6.625,P =0.023）,12-12＋6 （t =6.358,P =0.019）,13-13＋6 （t =5.254,P =0.004） gestational age in the observe group of children with the back of the neck translucency thickness compared with the control group.Fetal nasal bone length and gestational age was of straight linear correlation （r =0.801,P =0.038）.There was no continuity of nasal bone ultrasound images in the sagittal plane of middle facial in 21 cases of patients,and there were 19 cases of patients with the diagnosis of nasal bone missing,5 cases with diagnosis of dysplasia.Conclusion Actively carried out in prenatal ultrasound fetal neck transparent layer joint nasal bone measurement,has a very high value in the diagnosis of chromosomal abnormalities,can effectively improve the rate of diagnosis of chromosomal abnormalities.