超声检查对孕11～13^(+6)周胎儿神经系统畸形的诊断效果研究

Diagnostic Effect of Ultrasonography on Fetal Neurological Malformations at 11-13^(+6) Weeks Gestation

目的:分析超声检查对孕11~13^(+6)周胎儿神经系统畸形的诊断效果。方法:选择2014年1月-2016年12月在本院接受筛查孕11~13^(+6)周胎儿13082例,均经超声筛查,分析筛查结果。结果:13 082例胎儿经筛查后发现中枢神经系统畸形胎儿40例(0.31%),其中单胎妊娠38例(95.00%),双胎妊娠2例(5.00%);40例中枢神经系统畸形胎儿中包括无脑儿10例(25.00%)、颅脑畸形11例(27.50%)、前脑无裂13例(32.50%)、脑膜膨出3例(7.50%)、开放式脊柱裂2例(5.00%)、脊柱侧弯1例(2.50%);13 042例妊娠中晚期复查超声,其中15例检出存在神经系统畸形,包括单纯脑积水6例(40.00%)、脑积水+脊柱裂2例(13.33%)、小脑发育不良4例(26.67%)、小脑萎缩2例(13.33%)、蛛网膜囊肿1例(6.67%);妊娠早期及妊娠中晚期胎儿神经系统畸形经超声检出情况比较,差异有统计学意义(字2=11.3110,P=0.0008)。结论:超声检查对孕11~13^(+6)周胎儿神经系统畸形的诊断效果较好,具有无创、诊断准确率高、无痛等优点,值得进一步在临床应用推广。

Objective：To analyze the effect of ultrasonography on the diagnosis of fetal neurological malformations at 11-13＋6 weeks gestation.Method：From January 2014 to December 2016 in our hospital to receive screening 11-13＋6 weeks of fetuses 13 082 cases were selected,they were screened by ultrasound,analysis of screening results.Result：After screening of 13 082 fetuses,40 cases（0.31%） of central nervous system malformations were detected,included 38 cases（95.00%） of single pregnancy,2 cases（5.00%） of twin pregnancy,among the 40 cases of central nervous system malformation,10 cases（25.00%） of anencephalus,11 cases（27.50%） of craniocerebral malformation,13 cases（32.50%） of holoprosencephaly,3 cases（7.50%） of meningocele,2 cases（5.00%） of open spina bifida,1 case（5.00%） of scoliosis.13 042 cases of late pregnancy in the review of ultrasound,of which 15 cases found the presence of neurological malformations,6 cases（40.00%） of hydrocephalus,2 cases（13.33%） of hydrocephalus with spina bifida,4 cases（26.67%） of cerebellar dysplasia,2 cases（13.33%） of cerebellar atrophy,1 case（6.67%） of arachnoid cyst.The early pregnancy and late pregnancy fetal nervous system abnormalities by ultrasound detection were compared,the difference was statistically significant（X^2=11.3110,P=0.0008）.Conclusion：Ultrasonography is effective in the diagnosis of fetal neurological malformations at 11-13＋6 weeks gestation.It has the advantages of noninvasive, high diagnostic accuracy and painlessness,and is worthy of further application in clinical application.