超声测量不同孕周胎儿肝脏的长度及其临床意义

Ultrasonic measurement of fetal liver length and its clinical significance

目的 建立不同孕周正常胎儿肝脏长度指标 ,并观察胎儿宫内生长迟缓 (IUGR)、妊娠期糖尿病、母儿血型不合 3组异常妊娠妇女治疗前后胎儿肝脏长度的变化。方法 采用超声诊断仪分别测量妊娠 18～ 42周的 30 5例正常胎儿 ,及 2 4例IUGR、10例妊娠期糖尿病、16例母儿血型不合的妊娠妇女治疗前后胎儿的肝脏长度。结果 (1)正常妊娠胎儿肝脏长度与孕周密切相关 ,孕 2 8周前胎儿肝脏长度增长速度为每周 1 0 0mm ,孕 2 8周后肝脏增长速度为每周 1 76mm ,两者比较 ,差异有显著性 (P <0 0 5 )。 (2 )IUGR患者治疗前后胎儿肝脏增长速度分别为每周 1 19mm和 1 2 3mm ,低于正常胎儿 (P <0 0 5 )。 (3)妊娠期糖尿病患者治疗前后胎儿肝脏增长速度分别为每周 1 6 3mm和 1 6 3mm ,与正常胎儿比较 ,差异无显著性 (P >0 0 5 )。 (4 )母儿血型不合患者治疗前胎儿肝脏增长速度为每周 1 98mm ,和正常胎儿比较 ,差异无显著性 (P >0 0 5 ) ,治疗后胎儿肝脏增长速度为每周 1 38mm ,明显低于正常胎儿 (P <0 0 5 )。结论 胎儿肝脏长度变化可反映胎儿的宫内生长情况 。

Objective To establish the normal growth velocity of fetal liver length and compare them with those of intrauterine growth retardation, pregnant diabetes and maternal fetal blood types imcopatible. Method Three hundred and five normal pregnant women and 24, 10, 16 pathological pregnant women of intrauterine growth retardation (IUGR), gestational diabetes and maternal fetal blood types incompatible respectively had ultrasonographic measurement of fetal liver length at 18 to 42 weeks′ gestation Results Normal fetal liver length has a linear relation to gestational age, and showed a significantly rapid increase after 28th week with a growth rate of 1 76 mm per week, and 1 00 mm per week before 28th week ( P <0 05) The growth rate of IUGR group before and after therapy were 1 19 mm and 1 23 mm per week, significantly lower than those of normal group ( P <0 05) The growth rate of pregnant diabetes group before and after therapy were 1 63 mm and 1 63 mm per week, no statistical significance with normal group ( P >0 05) The growth rate of maternal fetal blood types incompatible group before therapy was 1 98 mm, showed no difference with normal group ( P >0 05), but after therapy, the growth rate of fetal liver was 1 38 mm per week, significantly lower than normal group ( P <0 05) Conclusion Dynamic measurement of fetal liver length can help us to understand whether the fetus grow well in uterus and whether the treatments are effective