连续顺序追踪超声法对早孕期胎儿严重肢体畸形产前诊断的研究

Study on continuous order tracking ultrasonic method of severe fetal limb deformity in early pregnancy

目的探究应用新技术对早孕期胎儿严重肢体畸形产前超声诊断价值。方法选择早孕期检查的孕妇5 843例初步筛选出147例疑似胎儿畸形,依次应用常规超声检查和连续顺序追踪超声法进行检查,并将常规超声检查结果记为对照组,连续顺序追踪超声法检查结果记为观察组。对比两种方法对早孕期胎儿肢体畸形的诊断结果,包括准确率、敏感性、特异性以及阳性预测值、阴性预测值等。结果经产后或临床结果得到肢体畸形胎儿为40例,占27.21%。观察组在对肢体缺失和其他肢体畸形检出率达到100%(14/14)和65.00%(13/20),显著高于对照组的50.00%(7/14)和5.00%(1/20)。但观察组在对手指畸形的检查未表现出优势。观察组检查的准确度、敏感性与阴性预测值为91.84%、70.00%、89.92%,均高于对照组的78.91%、22.50%、77.54%,差异均有统计学意义(P<0.05)。结论应用连续顺序追踪超声法对早孕期胎儿肢体畸形的检查准确度高,为产前诊断以及后期胎儿处理提供了充足的时间。

Objective To explore ultrasonographic diagnosis of severe fetal limb deformity in early pregnancy.Methods A total of 5 843 cases of pregnant women were screened and 147 cases of suspected fetal malformation were sellected.The routine ultrasound examination results were recorded as control group,and continuous order tracking ultrasonic method inspection results were recorded as observation group.The accuracy,sensitivity,specificity,positive predictive value,and negative predictive value was compared.Results The clinical results obtained in multiparous or limb malformation fetus were 40 cases,accounting for 27.21%.In the observation group on limb loss and other detection rate of 100%（14/14）and 65.00%（13/20）,significantly higher than those in control group 50.00%（7/14）and 5.00%（1/20）.But in the observation group on finger deformity examination showed no advantage.Observation accuracy,sensitivity and negative predictive value was 91.84%,70.00%,89.92%,which were higher than those in the control group（78.91%,22.50%,77.54%）.The differences were statistically significant（P〈0.05）.Conclusion The application of continuous order tracking ultrasonic method to check the first trimester fetal limb deformity with high accuracy,provided sufficient time for prenatal diagnosis of fetal treatment and late.