超声常规三切面与特殊切面法筛查唇腭裂胎儿的价值

Application value of conventional 3 sections and special cross section in the ultrasonic screening of cleft lip and palate in fetuses

目的:观察超声常规三切面与特殊切面法筛查唇腭裂胎儿的应用价值。方法:选取佛山市妇幼保健院6000例孕妇,对2556例胎儿唇腭部予以单一切面法(对照组),3444例胎儿唇腭部予以超声常规三切面+特殊切面法(观察组),以出生儿颜面部检查为"金标准",比较对照组与观察组检查结果灵敏度、特异度、准确性、阳性预测值、阴性预测值、漏诊率。结果:共47例(0.78%)唇腭裂;对照组20例(0.78%)唇腭裂,观察组27例(0.78%)唇腭裂,两组唇腭裂率比较无显著差异(P>0.05);单一切面法灵敏度60.00%,特异度99.88%,准确性99.57%,漏诊率40.00%,阳性预测值80.00%,阴性预测值99.69%,Kappa值0.68;超声常规三切面+特殊切面法灵敏度92.59%,特异度100.00%,准确性99.94%,漏诊率7.41%,阳性预测值100.00%,阴性预测值99.94%,Kappa值0.96。观察组筛查灵敏度、准确性及阴性预测值均明显高于对照组(P<0.05)。结论:超声常规三切面+特殊切面法可有效提高唇腭裂胎儿筛查准确性,具有较高应用价值。

Objective To investigate the application value of conventional 3 sections combined with special cross section in the ultrasound screening of fetal cleft lip and palate.Methods A total of 6000 pregnant women in Foshan Women and Children Hospital were enrolled in the study.The lips and palates of 2556 fetuses were examined by single section(control group),while the lips and palates of 3444 fetuses were examined by conventional 3 sections and special cross section(observation group).With the facial examination of neonates as the golden standard,the sensitivity,specificity,accuracy,positive predictive value,negative predictive value and the rate of missed diagnosis were compared between control group and observation group.Results There were 47 cases(0.78%)with cleft lip and palate,with 20 cases(0.78%)in control group and 27 cases(0.78%)in observation group.There was no significant difference in the rate of cleft lip and palate between two groups(P>0.05).The sensitivity,specificity,accuracy,the rate of missed diagnosis,positive predictive value,negative predictive value and Kappa value in control group were60.00%,99.88%,99.57%,40.00%,80.00%,99.69%and 0.68,respectively,while those in observation group were 92.59%,100.0%,99.94%,7.41%,100.00%,99.94%and 0.96,respectively.The sensitivity,accuracy and negative predictive value in observation group were significantly higher than those in the control group(P<0.05).Conclusion The conventional 3 sections combined with special cross section in ultrasonic examination can effectively improve the screening accuracy of fetal cleft lip and palate,with a higher application value.