超声对孕早期肠系膜上动脉上翘征的观察及应用研究

Observation and application of ultrasonography on the upwarping of superior mesenteric artery in early pregnancy

目的通过超声检查对早期妊娠胎儿肠系膜上动脉上翘征的观察及研究。方法选取最近5年本院收治的100例妊娠周期在12周左右的孕妇为研究对象,使用PhilipsiU22、GEVolusonE8、PhilipsEpiq7彩色多普勒超声诊断仪中的腹部探头,探头频率控制在4MHz左右,选择胎儿NT检查方式以及HD-Flow显像学检查,取胎儿超声矢状位扫查,以胎儿的胸腹腔为中心进行检查,彩色血流采用低流速量程或者能量多普勒影像,来表达腹主动脉与肠系膜上动脉(SMA)。检查结束后观察孕早期孕妇的各项生理指标。在两者间的角度超过90°时,肠系膜上动脉延伸方向改为上方,判定为先天性膈疝;当之间的角度在60°~90°之间时,肠系膜上动脉的延伸方向为脐带根部,判定为脐膨出。通过上述检查分析研究对象的影像学资料和临床症状。结果通过使用PhilipsiU22型、GEVolusonE8、PhilipsEpiq7彩色多普勒超声诊断仪进行检查,共筛查出28例畸形胎儿,其中出现脐膨出的有19例,出现膈疝的有1例,出现腹壁裂的有8例。同时发现还有部分胎儿结合其他畸形,主要包括:NT增厚的有10例(NT值为2.7~10.6mm);静脉导管a波反向和脊柱异常的各有7例;四肢异常的有4例;出现水肿的有3例;面部异常的有2例;颈项部水囊状淋巴管瘤和颅内异常的各有2例。结论通过上述研究发现,超声检查能够在妊娠早期有效检查出胎儿脐膨出、腹壁裂及先天性膈疝,不仅能帮助孕妇及其家属早期判断是否需要继续妊娠,同时可减轻孕妇及其家庭的精神及经济负担具有重要意义。

Objective To observe and study the upwarps of superior mesenteric artery in fetus in early pregnancy by ultrasonography. Methods The study selected 100 pregnant women who had been in our hospital for the last 5 years and had a pregnancy cycle of around 12 weeks, using a Philips iU22, GE Voluson E8, Philips Epiq7 color doppler ultrasonic diagnostic apparatus of abdominal probe, probe frequency control at around 4 MHz, choose fetal NT check way and HD - flow imaging studies, take fetal ultrasound sagittal scan, check for the center with fetal thoracic abdominal cavity, color doppler blood flow with low velocity range or energy images. To express the abdominal aorta and superior mesenteric artery (SMA), and observe the physiological indicators of pregnant women in the early pregnancy after the examination. When the angle between the two was more than 90°, the superior mesenteric artery was changed to the upper direction, which was judged as congenital diaphragmatic hernia. When the angle is between 60° and 90°, the extension direction of the superior mesenteric artery is the root of the umbilical cord, which is judged as omphalocele. The imaging data and clinical symptoms of the subjects were analyzed through the above examinations. Results A total of 28 malformed fetuses were detected by Philips iU22, GE Voluson E8 and Philips Epiq7. Among them, 19 had omphalocele, 1 had diaphragmatic hernia and 8 had abdominal wall fissure. At the same time, it was found that some fetuses were combined with other malformations, including 10 cases with NT thickening (NT value was 2.7-10.6 mm). There were 7 cases with reverse a-wave of venous catheter and abnormal spine. Abnormal limbs were found in 4 cases. There were 3 cases of edema. There were 2 cases with facial abnormality. There were 2 cases of hydrocystic lymphangioma of neck and 2 cases of intracranial abnormality. Conclusion Through the above research, it is found that ultrasound examination can effectively detect fetal omphalocele, abdominal wall fissure and congenital diaphragmatic hernia in the early pregnancy, which can not only help pregnant women and their families to judge whether they need to continue pregnancy in the early stage, but also reduce the mental and economic burden of pregnant women and their families.