二维和三维超声联合应用对中孕胎儿畸形的诊断价值

The Diagnosis Value of Combined Application Two-dimensional and Three-dimensional Ultrasound in Middle Pregnancy Fetus

目的：探究老年患者无痛胃镜术中应用地佐辛与丙泊酚的疗效。方法：选取2012年6月-2014年6月在本院接受治疗的95例行无痛胃镜术的老年患者作为本次研究试验对象,观察组采用地佐辛和丙泊酚进行麻醉,对照组采用盐酸瑞芬太尼和丙泊酚进行麻醉,观察比较两组患者的麻醉效果、各项体征指标和不良反应发生情况。结果：T2时,观察组患者的MAP和HR较T1时均明显降低,观察组的MAP明显高于对照组,差异均有统计学意义（P〈0.05）,同时期对照组患者的MAP和Sp O2较T1时均明显降低,差异均有统计学意义（P〈0.05）;T3时,观察组患者的HR明显低于观察组,而Sp O2值稍高于对照组,比较差异均有统计学意义（P〈0.05）。观察组患者平均麻醉起效、清醒时间均明显短于对照组,VAS评分明显低于对照组,总不良反应发生率10.42%明显低于对照组的38.30%,比较差异均有统计学意义（P〈0.05）。结论：老年行无痛胃镜手术患者使用地佐辛联合丙泊酚的麻醉疗效较好,术中麻醉起效快,疼痛小,有利于胃镜手术的实施,麻醉清醒时间短,术后患者不良反应少,安全性高,值得广泛推荐使用于临床当中。

Objective： To investigatethe prenatal diagnosis value of using the two-dimensional and three- dimensional ultrasound application in fetal malformation.Method： 445 cases of fetal malformation in 22-28 weeks were found by the combined application of two-dimensional and three-dimensional ultrasound from January 2009 to December 2014, their prenatal examination ultrasonic image and the clinical data were retrospective analyzed. Result： The brain development abnormality were 71 cases （ 16% ）, facial deformity were 44 cases （ 10% ）, cardiac anomalies were 82 cases （ 18% ）, thoracic dysplasia were 17 cases （ 4% ）, urinary system abnormalities were 52 cases （ 12% ）, abnormal gastrointestinal and abdominal wall were 53 cases （ 12% ）, skeletal dysplasia were 45 cases （ 10% ）, multiple malformations were 40 cases （ 9% ）, fetal edema were 41 cases （ 9% ） ; and abnormal fetal appendages were 52 cases. All the diagnosis were tested and verified by the provincial maternal and child care service centre, or all the fetus malformation features were the same as the clinic cases in our hospital.Conclusion： The two-dimensional ultrasound and the three-dimensional ultrasound combined application, has a high accuracy rate in diagnose the fetal malformation, and it is superior than one-way examining method. Rationally using the two kinds of examining methods has a great clinic value for improving the accuracy rate in prenatal diagnosis.It is an effective method for antenatal screening.