探讨二维超声与四维超声联合筛查胎儿畸形的临床价值

To Study the Clinical Value of Two Dimensional Ultrasonography and Four Dimensional Ultrasonography in Screening Fetal Malformations

目的分析在胎儿畸形筛查中联合应用四维超声与二维超声的临床价值,为临床提供更安全有效的筛查方法。方法选取2018年12月至2020年12月在我院进行常规产前检查的患者120例,根据筛查方式的不同分为3组,即观察组(应用二维+四维超声进行筛查)、二维超声组(应用二维超声进行筛查)和四维超声组(应用四维超声进行筛查),每组患者40例。对比胎儿畸形的具体情况、3组胎儿畸形的筛查结果以及筛查的准确度、特异度、敏感度。结果120例患者中,经引产后或胎儿出生后证实,胎儿畸形共38例,其中,有14例体表畸形,有9例脑及神经系统畸形,有4例心脏畸形,有4例泌尿生殖系统畸形,有4例四肢畸形,有2例颜面部畸形,有1例消化系统畸形。观察组的胎儿畸形检出率显著高于二维超声组、四维超声组;观察组的胎儿畸形漏诊率、无法判断率均显著低于二维超声组、四维超声组,差异具有统计学意义(P<0.05)。观察组的准确度、特异度及敏感度均显著高于二维超声组、四维超声组的,差异具有统计学意义(P<0.05)。结论对于产前胎儿畸形的筛查,四维超声联合二维超声可提高胎儿畸形的检出率,准确分辨胎儿各种畸形类型,避免漏诊、无法判断等情况的发生。

Objective To analyze the clinical value of combined use of four-dimensional ultrasound and two-dimensional ultrasound in fetal malformation screening,and to provide a more safe and effective screening method.Methods From December 2018 to December 2020,120 patients undergoing routine prenatal examination were divided into three groups according to different screening methods,they were divided into observation group(using two-dimensional+four-dimensional ultrasound for screening),two-dimensional ultrasound group(using two-dimensional ultrasound for screening)and four-dimensional ultrasound group(using four-dimensional ultrasound for screening),40 patients in each group.To compare the specific conditions of fetal malformations,the screening results of three groups of fetal malformations,and the accuracy,specificity,sensitivity of screening.Results Among the 120 patients,38 cases of fetal malformations were confirmed after induction of labor or after the birth of the fetus.Among them,14 cases had surface malformations,9 cases had brain and nervous system malformations,4 cases had cardiac malformations,and 4 cases had urogenital malformations,4 cases of limb deformities,2 cases of facial deformities,and 1 case of digestive system abnormalities.The detection rate of fetal malformations in the observation group was significantly higher than that of the two-dimensional ultrasound group and the four-dimensional ultrasound group;the missed diagnosis rate and the undiagnosed rate of fetal malformations in the observation group were significantly lower than those of the two-dimensional ultrasound group and the four-dimensional ultrasound group.The difference was statistically significant(P<0.05).The accuracy,specificity and sensitivity of the observation group were significantly higher than those of the two-dimensional ultrasound group and four-dimensional ultrasound group,and the difference was statistically significant(P<0.05).Conclusion Four-dimensional ultrasound combined with two-dimensional ultrasound can improve the detection rate of fetal malformations,accurately identify various types of fetal malformations,and avoid missed diagnosis,unable to determine the occurrence of the situation.