彩色多普勒超声筛查胎儿神经系统畸形临床意义

Application of color doppler ultrasound in prenatal screening for fetal nervous system malformations

目的胎儿神经系统畸形易造成较高死亡率和致畸率,产前明确诊断尤为重要。本研究探讨产前超声检查在诊断筛查胎儿神经系统畸形中的应用价值。方法对2014-02-03-2017-01-09于郑州市妇幼保健院行产前超声检查的65 328例产检孕妇的超声检查结果进行分析,对存在神经系统畸形的孕妇和胎儿结局展开随访,追踪病理结果,分析神经系统畸形类型的分布及其与病理结果诊断的符合度;分析神经系统畸形超声检出时间;分析不同年龄孕妇胎儿神经系统畸形发生率差异。结果 99例孕妇被诊断出神经系统畸形,畸形发病率为0.15%;侧脑室扩张和神经管缺陷是主要畸形类型,分别占比29.29%和16.16%;超声对侧脑室扩张、神经管缺陷、胼胝体发育不全及全前脑均存在1例漏诊。>24~35岁孕妇胎儿神经系统畸形发生率为0.10%,低于≤24岁组的1.25%和>35岁组的1.76%,χ~2=348.3,P<0.05;超声检出时间和例数分别为<12周2例,12~17周25例,>17~25周41例,>25~36周22例,>36周9例。结论超声对胎儿神经系统畸形具有较高诊断准确率,且操作简便,价格低廉,是临床较好的诊断筛查手段。

OBJECTIVE As fetal nervous system malformations can easily lead to higher mortality and teratogenicity,prenatal diagnosis is especially important.The study aims to investigate the clinical value of prenatal ultrasonography in the diagnosis of fetal nervous system malformations:METHODS The prenatal ultrasonic examination results of 65328 cases were analyzed in Women and Children's Hospital of Zhengzhou from February 3,2014 to January 9,2017.The fetus cases with nervous system malformations were follow-up for pathological results.It was analyzed the distribution of types of nervous system abnormalities,the consistence with pathological results,the optimal test time of prenatal ultrasonography and the difference of malformation rates in pregnant women with different ages.RESULTS Totally 99 cases of pregnant Women were diagnosed as fetal nervous system abnormalities,and abnormal incidence was 0.15%.Dilated lateral ventricles and neural tube defects were the main types of deformity,respeetively accounted for 29.29% and 16.16%.There were missed diagnoses including 1 case with lateral ventricles,1 case with neural tube defects,1case with agenesis of.the corpus callosum and I case with holoprosencephaly.The incidence of fetal nervous system malformations in >24-35 years old pregnant women was 0.10%,lower than 1.25% in 424 years old pregnant women group and 1.76% in >35 years old pregnant women group,x^2=348.3,P<0.05.The ultrasonic detection time and number of cases with fetal nervous system malformations were 2 cases <12 weeks,25cases of 12-17 weeks,41 cases of >17-25 weeks,22 cases of >25-36 weeks,and 9 cases >36 weeks.CONCLUSIONS Ultrasound has higher diagnostic accuracy for fetal nervous system malformations,and it is easy to operate and low in price.It is a better method for clinical diagnosis and screening fetal nervous system malformation.