目的：探讨二维超声联合四维超声在不同妊娠周期产前筛查胎儿畸形中的价值。方法：选取于东莞市横沥医院进行产前检查的1868例不同妊娠周期的妊娠期妇女，所有妊娠期妇女先进行二维超声检查，对初步怀疑胎儿畸形的妊娠期妇女进行二维超声联合四维超声检查。以临床分娩结果为依据，对比分析二维超声及其联合四维超声检查的诊断率。结果：妊娠周期为11～17＋6周妊娠期妇女的二维超声检查确诊率为62．96％（17／27），18～27＋6周妊娠期妇女二维超声检查确诊率为86．59％（71／82），28～40＋6周妊娠期妇女二维超声检查确诊率为70．59％（12／17），明显低于二维超声联合四维超声检查的92．59％（25／27）、97．56％（80／82）、94．12％（16／17），差异有统计学意义（P＜0．05）。结论：超声检查是产前筛查胎儿畸形的重要手段，二维超声联合四维超声检查在不同妊娠周期产前筛查胎儿畸形中的应用价值较高，能有效提高胎儿畸形的诊断率，减少畸形胎儿的出生率，值得临床推广。%OBJECTIVE: To evaluate the application value of two-dimensional ultrasonography combined with four-dimensional ultrasonography in prenatal screening of fetal abnormalities at different weeks of gestation.METHODS:A total of 1 868 pregnancy women at different gestational weeks undergoing prenatla examination in Dongguan Hengli Hospital were given two-dimensional ultrasonography, for those who were initially suspected as having fetal anomaly were given two-dimensional ultrasonography combined with four-dimensional ultrasonography.Based on the results of clinical delivery,the diagnostic accuracy of two-dimensional ultrasonography alone vs. two-dimensional ultrasonography combined four-dimensional ultrasonography was analyzed.RESULTS:The diagnostic accuraracy of the two-dimensional ultrasonography for pregnant women at 11-17+6 gestational weeks,18-27+6 weeks and 28-40+6 weeks was signficantly lower than that of the two-dimensional ultrasonography combined four-dimensional ultrasonography [62.96%(17/27),86.59%(71/82) and 70.59%(12/17 ), respectively, as agaist 92.59%( 25/27 ), 97.56%( 80/82 ), 94.12%( 16/17 ), respectively, P <0.05 ]. CONCLUSIONS: Ultrasonography is an important means for prenatal screening of fetal anomaly, combination of two-dimensional ultrasonography with four-dimensional ultrasonography is of great diagnostic value in prenatal screening for fetal anomaly in pregnant women of different gestational weeks in that it can effectively improve diagnostic accuracy of fetal anomaly,reduce the birth rate of fetuses with fetal anomaly,which thus is worth clinical promotion.
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