连续顺序追踪超声法检测胎儿骨骼肢体畸形的临床应用效果

摘要

Objective To explore the value of sequential tracking ultrasound in detecting fetal skeletal limb deformities.Methods Clinical records of 2 100 pregnant women (11-13 +6 weeks) who had ultrasound examination in Beijing United Family Hospital from August 2015 to May 2017 were reviewed.Results of sequential tracking ultrasound and traditional ultrasound examination and follow-up records were analyzed.Results Thirty (1.4％) fetuses were diagnosed of skeletal limb deformities after birth;the mean crown-rump length was (6.9 ±1.2)cm;the mean neck transparent layer thickness was (5.0 ± 1.0) mm.Detection rates of limb deficiencies,thanatophoric dysplasia and congenital clubfoot of sequential tracking ultrasound were significantly higher than those of traditional ultrasound [14/14 vs 8/14,4/4 vs 1/4,5/6 vs 1/6] (P ＜ 0.05);detection rate of finger deformities showed no significant difference between 2 examinations (P ＞ 0.05).Diagnostic sensitivity and specificity of sequential tracking ultrasound for skeletal limb deformities were 86.7％ and 100.0％,which were significandy higher than those of traditional ultrasound (40.0％ and 100.0％) (P ＜ 0.05).Conclusion Sequential tracking ultrasound is effective and accurate in early diagnosis of fetal limb deformities.%目的 探讨连续顺序追踪超声法检测胎儿骨骼肢体畸形应用效果.方法 采用随机抽样与回顾性研究方法,收集2015年8月到2017年5月在北京和睦家医院行早孕期(11～13+6周)超声检查的2 100例孕妇的临床资料.所有患者均给予了连续顺序追踪超声法与传统超声法检测,记录超声与随访结果.结果 在2 100例孕妇中,经产后确诊胎儿骨骼肢体畸形30例(1.4％),平均头臀长为(6.9±1.2)cm、颈部透明层为(5.0±1.0)mm.连续顺序追踪超声法肢体缺失、致死性骨发育不良、先天性马蹄内翻足的检出率高于传统超声法[14/14比8/14、4/4比1/4、5/6比1/6],差异有统计学意义(P＜0.05),而手指畸形的检出率2组差异无统计学意义(P＞0.05).连续顺序追踪超声法骨骼肢体畸形的诊断敏感度与特异度分别为86.7％和100.0％,传统超声法分别为40.0％和100.0％,连续顺序追踪超声法的诊断敏感度高于传统超声法,差异有统计学意义(P＜0.05).结论 连续顺序追踪超声法检测胎儿骨骼肢体畸形的效果比较好,能在早期及时、准确发现骨骼肢体畸形胎儿,提高诊断效果.