Dus和NST对产前诊断胎儿脐带绕颈的临床意义

Clinical value of color Doppler ultrasonography and non-stress test in prenatal diagnosis of umbilical cord around the neck

目的 评价彩色多普勒超声 (Dus)和胎心监护(NST)对产前诊断胎儿脐带绕颈的临床意义 ,以期提高诊断符合率。 方法 对826例晚期妊娠孕妇产前1～10d行Dus和NST检查预测胎儿脐带绕颈 ,按不同检查方法分为Dus组、NST组和联合组。记录3组脐带绕颈的预测数和实际发生数 ,计算各自的诊断符合率、阴性预测值、敏感性、特异性和准确率。 结果 Dus组患者和NST组患者的诊断符合率分别为86.5 %和87.2% ;联合组94.0 % ,较前2组明显提高 (χ2=17.38,P<0.01) ,且敏感性、特异性和准确率均有提高 (χ2=7.77、20.85和9.97 ,均P<0.01)。 结论 Dus和NST对产前诊断胎儿脐带绕颈具有相近的临床意义 ,NST联合Dus检查能大大提高胎儿脐带绕颈的诊断符合率。

Objective To investigate the clinical value of color Doppler ultrasonography(Dus)and non-stress test(NST)in prenatal diagnosis of umbilical cord around neck.Methods Eight hundred twenty six pregnant women were studied within1～10days before delivery by Dus and/or NSTto predict umbilical cord around neck,they were divided into Dus group,NSTgroup and the combined group according to different methˉods.The predictive numbers and actual numbers were recorded and the rate of diagnostic coincidence,negative predictive value,sensitivity,specificity and accuracy were calculated.Results The rate of diagnostic coincidence was86.5%in Dus group and87.2%in NSTgroup,while it was94.0%in the combined group(χ 2 =17.38,P<0.01).The sensitivity,specificity and accuracy rate were also improved in the combined group(χ 2 =7.77,20.85and9.97,P<0.01).Conclusion NST has the same clinical value as Dus in prenatal diagnosis of umbilical cord around neck and combined application of Dus and NSTcould remarkably increase the rate of diˉagnostic coincidence.