目的 分析定性与定量法相结合共同预测巨大儿的临床应用,对选择分娩方式提供参考. 方法 回顾性分析内蒙古医科大学第三附属医院1 196例分娩孕妇的资料,其中巨大儿病例139例. 应用4种方法预测巨大儿(①宫高+母体腹围≥140cm;②宫高≥35cm,同时胎儿腹围≥35cm;③临床法;④超声法) ,于出生后5min内测量并准确记录新生儿出生体重,探讨最佳预测巨大儿的方法. 结果 超声法预测巨大儿的灵敏度和特异度最高,分别为87.05%和98.24%,其次为宫高≥35cm,同时胎儿腹围≥35cm,而宫高+母体腹围≥140cm灵敏度和特异度最低,分别为51.08%和67.64%. 超声法预测巨大儿的阳性预测值和阴性预测值均最高,分别为85.21%和98.49%,而宫高+母体腹围≥140cm法最低,分别为15.50%和92.25%. 结论 定性与定量法共同预测巨大儿具有重要的临床应用价值,其中超声法是预测胎儿体重的最佳方法,宫高+母体腹围预测价值最低.%Objective To analyze the clinical application of qualitative method combined with quantitative method in predicting fetal macrosomia and thus provide reference for selecting delivery mode.Methods Retrospective analysis was conducted on the data of 1 196 pregnant woman delivering in the Third Clinical Hospital of Inner Mongolia Medical College, including 139 cases giving birth to macrosomia.Four methods were used to predict fetal macrosomia, uterine height and maternal abdominal circumference≥140cm, uterine height≥35cm and fetal circumference≥35cm, clinical method, and ultrasound method.Neonatal birth weight of fetal macrosomia was measured and recorded within 5 minutes after birth, and the best predicting method was explored.Results The sensitivity and specificity of ultrasound method in predicting fetal macrosomia were highest, and they were 87.05%and 98.24%, respectively, followed by the second method.The sensitivity and specificity of the first method was lowest and they were 51.08% and 67.64%, respectively.The positive predictive value and negative predictive value of ultrasound method in predicting fetal macrosomia were highest, and they were 85.21%and 98.49%, respectively.But the first method had the lowest positive predictive value and negative predictive value (15.50%, 92.25%). Conclusion Qualitative method combined with quantitative method has significant clinical value in predicting fetal macrosomia.Ultrasound method is the best method for prediction of fetal weight, but the values predicted with uterine height and maternal abdominal circumference method are lowest.
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