三维超声诊断单脐动脉的意义及其区域性(烟威地区)概率分析

The significance of three-dimensional ultrasound diagnosis of single umbilical artery and regional(Yan-Wei region)probability analysis

目的探讨三维超声诊断单脐动脉的意义、分析烟威地区单脐动脉合并胎儿先天结构畸形的概率。方法利用三维超声诊断单脐动脉及回顾性分析烟威地区(籍贯为烟威地区或在户口所在地居住20年以上的入选本研究)31273例接受产前三维超声筛查所确诊的单脐动脉及其合并先天结构畸形的类型。结果 31273例产检孕妇筛查出单脐动脉83例,其中合并胎儿先天性结构畸形21例,发生率为25.30%(21/83);单脐动脉合并多发畸形较单发畸形多见,其中伴发1种畸形者8例,占38.10%(8/21);复合畸形(合并2种及2种以上)者13例,占61.90%(13/21)。合并畸形类型位居前三位的是心血管系统、泌尿系统、中枢神经系统。结论三维超声较二维超声进行产前单脐动脉的筛查更敏感、特异、准确;烟威地区单脐动脉合并胎儿结构畸形以心血管系统、神经系统及泌尿系统为主,但其概率数值及位次分布与之前的国内外报道有一定的差距:首先是前三位的排序差距,再者是前三位之间的概率数值差距。虽然合并畸形前三位中心血管系统位列第一(为42.86%),但与其他两者概率(神经系统与泌尿系统均为38.10%)差异没有统计学意义(P>0.05)。考虑这种差距的出现与区域性也有一定的相关性。

Objective To explore the significance of three dimensional ultrasound diagnosis of single umbilical artery ,analysis the Yan-wei region of single umbilical artery combined probability of fetal congenital deformity .Methods Using three-dimen-sional ultrasound in the diagnosis of single umbilical artery ,Yan-wei region were retrospectively analyzed （native place for Yan-wei area or live in the registered permanent residence for more than 20 years in this study） ,31273 cases of antenatal and three-dimensional ultrasound screening and diagnosis of single umbilical artery by merger type of congenital deformity .Results 31273 cases of prenatal screening out the single umbilical artery ,83 cases of pregnant women ,the combination of 21 cases of fetal congenital deformity ,the rate was 25 .30% （21/83）;Single umbilical artery malformations merge multiple malformation is rela-tively single ,including 1 with deformity 8 cases accounted for 38.10% （8/21）;Complex malformation （merge two and more than 2） 13 cases accounted for 61.90% （13/21）;The top three of merge malformation type is cardiovascular system ,urinary tract ,central nervous system .Conclusion Three-dimensional ultrasound make prenatal SUA than two -dimensional ultrasound is more sensitive ,specific and accurate ;Yan-wei region of single umbilical artery with fetal abnormalities in cardiovascular sys-tem ,nervous system and urinary system is given priority to ,but just before the probability values and power distribution and re-ports at home and abroad have a certain gap ：the first is the sort of top three disparities ,moreover is the probability that the val-ue gap between the top three .Although the three combined deformities center topped the cardiovascular system （42.86% ） ,but with the other two probability （nerve system and urinary system are 38.10% ） difference no statistical significance （P〉 0.05） . Considering the appearance of this gap and regional also to have certain relevance .