连续顺序追踪超声法对早孕期胎儿肢体畸形筛查价值的临床研究

Clinical study on the screening value of ultrasound using a systematic continuous sequence approach for fetal limb deformities during the first trimester of pregnancy

目的：探讨连续顺序追踪超声法对早孕期胎儿肢体畸形筛查的价值。方法：选取2011年10月-2013年12月间在该院进行早孕期胎儿肢体畸形筛查的孕妇3 798例,均行连续顺序追踪超声法检查,随访观察胎儿的出生或引产结果,分析连续顺序追踪超声法在早孕期胎儿肢体畸形筛查中的灵敏度、特异度、准确度,分析连续顺序追踪超声法检查结果与胎儿出生或引产结果的一致性。结果：连续顺序追踪超声法在早孕期胎儿肢体畸形筛查中的灵敏度为94.28%、特异度为99.95%、准确度为99.89%。连续顺序追踪超声法检查结果与胎儿出生或引产结果具有高度的一致性（Kappa=0.002,P=0.808）。结论：连续顺序追踪超声法是早孕期胎儿肢体畸形筛查的有效方法,具有高灵敏度、高特异度、高准确度的特点,值得临床推广使用。

Objective： To explore the value of ultrasound using a systematic continuous sequence approach for screening of fetal limb deformities during the first trimester of pregnancy. Methods： A total of 3 798 pregnant women receiving fetal limb deformities screening during the first trimester of pregnancy in the hospital from October 2011 to December 2013 were selected, all the pregnant women underwent ultrasonography using a systematic continuous sequence approach, the fetal outcomes were followed up and observed; the sensitivity, specificity and accuracy of ultrasound using a systematic continuous sequence approach in screening of fetal limb deformities during the first trimester of pregnancy were analyzed ; the consistency of ultrasonographic results using a systematic continuous sequence approach and results of fetal birth or induced labor was also analyzed. Results： The sensitivity, specificity and accuracy of ultrasound using a systematic continuous sequence approach in screening of fetal limb deformities during the first trimester of pregnancy were 94. 28%, 99. 95% and 99. 89%, respectivelY. The consistency of ultrasonographic results using a systematic continuous sequence approach and results of fetal birth or induced labor was high （ Kappa = 0. 002, P = 0. 808 ） . Conclusion： Ultrasound using a systematic continuous sequence approach in screening of fetal limb deformities during the first trimester of pregnancy is effective, which has the advantages of high sensitivity, high specificity and high accuracy, which is worth clinical popularizing and applying.