早孕期超声规范化结构筛查在胎儿四肢畸形诊断中的应用效果

Application effect of ultrasound standardized structure screening in early pregnancy in the diagnosis of fetal limb deformity

目的探讨基于连续顺序追踪的早孕期超声规范化结构筛查在胎儿四肢畸形诊断中的应用效果。方法回顾性分析本院2017年1月25日至2019年1月18日收诊的600例疑似存在胎儿四肢畸形的早孕期孕妇的临床资料,且均行常规超声以及基于连续顺序追踪的早孕期超声规范化结构筛查。将生产后胎儿或引产后胎儿出现的肢体畸形状况作为本研究的金标准。统计分析基于连续顺序追踪的早孕期超声规范化结构筛查与常规超声对胎儿肢体畸形的诊断结果,并比较两种检查方式的诊断效能及对胎儿肢体畸形检出情况。结果基于连续顺序追踪的早孕期超声规范化结构筛查诊断胎儿肢体畸形的特异度、灵敏度及准确度分别为98.65%(513/520)、97.50%(78/80)、98.50%(591/600),均高于常规超声的91.73%(477/520)、52.50%(42/80)、86.50%(519/600),差异具有统计学意义(P<0.05)。基于连续顺序追踪的早孕期超声规范化结构筛查对足内翻、屈曲指、肢体姿势异常、裂手畸形及肢体缺失等胎儿肢体畸形的总检出率高于常规超声,差异具有统计学意义(P<0.05)。结论基于连续顺序追踪的早孕期超声规范化结构筛查有助于提高胎儿四肢畸形的诊断效能,值得临床推广应用。

Objective To investigate the application effect of ultrasound standardized structure screening in early pregnancy based on sequential tracking in the diagnosis of fetal limb deformity.Methods The clinical data of 600 pregnant women in early pregnancy suspected of fetal limb deformity admitted in our hospital from January 25,2017 to January 18,2019 were retrospectively analyzed,all pregnant women underwent conventional ultrasound and ultrasound standardized structure screening in early pregnancy based on sequential tracking.The limb deformities of the fetus after birth or induced labor were taken as the gold standard of this study.The diagnosis results of fetal limb deformity by ultrasound standardized structure screening in early pregnancy based on sequential tracking were statistically analyzed,and the diagnostic efficiency and detection of fetal limb deformity were compared between the two methods.Results The specificity,sensitivity and accuracy of ultrasound standardized structure screening in early pregnancy based on sequential tracking in the diagnosis of fetal limb deformity were 98.65%(513/520),97.50%(78/80),98.50%(591/600),which were higher than 91.73%(477/520),52.50%(42/80),86.50%(519/600)of conventional ultrasound,and the differences were statistically significant(P<0.05).The total detection rate of fetal limb deformity such as foot varus,flexion fingers,abnormal limb posture,cleft hand deformity and limb loss in ultrasound standardized structure screening in early pregnancy based on sequential tracking was higher than that in conventional ultrasound,and the difference was statistically significant(P<0.05).Conclusion Ultrasound standardized structure screening in early pregnancy based on sequential tracking is helpful to improve the diagnostic efficiency of fetal limb deformity,which is worthy of clinical promotion and application.