在农村基层医院开展产前超声检查的临床意义及体会(附237例报告)

The clinic significance and experience of prenatal ultrasound used in the diagnosis of fetal malformation in countryside basic-level hospital

目的探讨在农村基层医院开展产前超声检查的意义并介绍体会。方法2013年1月至2014年12月间,利用超声对13 295例孕龄在14~38周孕妇进行系统检查,对每例超声检出的胎儿畸形及其他异常进行跟踪随访,并与引产、分娩、病理解剖、上级医院超声、MR诊断等结果对比、分析。结果13 295例初检孕妇中,共检出237例异常胎儿,检出率1.78%;漏诊6例,漏诊率2.47%（6/243）;4例误诊,诊断符合率98.3%（233/237）。结论随着我国＂单独二孩＂政策的实施后面临的生育高峰,在农村基层医院开展超声产前系统检查,不仅具有很高的临床价值,而且对于降低本地区不良出生率、提高人口质量、减低家庭和社会经济负担、消除因不良出生儿童所带来的精神压力均具有积极的社会效益。农村基层医院开展系统产前超声检查的关键是要培养专业超声人才,技术难点是胎儿心脏畸形的诊断。

Objective To evaluate the clinical significance and present experience of prenatal ultrasound examination in countryside basic-level hospitals.Methods Between January 2013 and December 2014,13295 cases of pregnant women were checked systematically by prenatal ultrasound,these women＇s gestational age were between 14-38weeks.Followed up for each case,to analysis with induced labor,delivery,the results of pathological anatomy,the diagnosis of ultrasound examination of professor in superior hospital and MR.Results Among 13 295 cases of pregnant women screened firstly,237 abnormal fetus were detected, The detection rate was 1.78%.Besides,there were 6cases of missed diagnoses（2.47%,6/243）and 4cases misdiagnosed.The diagnosis coincidence rate was 98.3%（233/237）.Conclusion Along with our country were carring out the new policy of＂selective two-child＂,we had faced the baby boom.The prenatal ultrasound screening in countryside basic-level hospitals,not only has high clinical value,but also has positive social benefits in reducing adverse birth rate in this region,improving population quality,reducing the family and social economic burden,and eliminating with mental stresss of those family members because of those disability children.The key of carring out the systematic prenatal ultrasound examination in the countryside basic-level hospitals is to train the professional doctors in basic-level hospitals,and the difficult of technical is the diagnosis of fetal cardiac malformations.