彩超在产前估测脐带长度中的应用研究

Application of Color Doppler Ultrasound in Prenatal Estimation of Umbilical Cord Length

目的研究彩超在产前估测脐带长度中的应用价值。方法 2017年1—12月,随机选取晚孕期(孕32周后)孕妇1 000例。以四象限计数法对脐带长度产前进行超声估测,产后由产科医师对每例胎儿脐带进行测量。收集有效数据645例。对每个病例进行详细登记,资料档案录入,建立数据库进行真实数据录入。结果在645例晚孕期孕妇中,产前超声检测脐带分布在1个象限者,共29例,产后实际测量脐带平均长度(41±6)cm,其中脐带过短15例;产前超声检测脐带分布在2个象限者,共451例,产后实际测量脐带平均长度(52±2)cm,其中脐带过短3例;产前超声检测脐带分布在3个象限者,共149例,产后实际测量脐带平均长度(53±3)cm;产前超声检测分布在个4象限者,共16例,产后脐带平均长度(79±8)cm;产前超声检测脐带分布3、4个象限者,产后脐带长度均为正常值范围。产前超声检测诊断脐带正常的符合率98.24%;诊断脐带过短的符合率62.07%。结论超声四象限计数法对产前估测脐带长度有一定价值,尤其是对脐带过短的诊断,在分娩前给予及时预警,可减小产科风险,降低新生儿窒息发生率。

Objective To explore the effect of color Doppler ultrasound in prenatal estimation of umbilical cord length.Methods 1 000 pregnant women(after 32 weeks of gestation)were randomly selected from January to December 2017.The length of the umbilical cord was estimated by ultrasonography and measured by obstetrician after birth.Effective data of 645 cases was collected.Each case was registered in detail,data files were recorded,and a data base was established for real data entry.Results Among the 645 pregnant women with late pregnancy,prenatal ultrasound examination showed a total of 29 cases with umbilical cord distribution in one quadrant,and the postoperative actual measurement showed the average umbilical cord length was(41±6)cm,and including 15 cases with short umbilical cord;451 cases with umbilical cord distribution in two quadrants,the average umbilical cord length was(52±2)cm,including 3 cases of short umbilical cord.149 cases with umbilical cord distribution in three quadrants,and the average umbilical cord length was(53±3)cm.16 cases with umbilical cord distribution in four quadrants,and the average umbilical cord length was(79±8)cm.The women whose prenatal ultrasound examination with umbilical cord distribution in three or four quadrants,the postoperative umbilical cord length was in normal range.The compliance rate of normal umbilical cord diagnosed by ultrasound examination was 98.24%.The compliance rate of short umbilical cord diagnosed was 62.07%.Conclusion Ultrasonic four-quadrant counting method has a certain value for prenatal estimation of umbilical cord length,especially for the diagnosis of short umbilical cord,it provides timely warning before delivery,reduces the risk of obstetrics and the incidence of neonatal asphyxia.