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目的:生长发育评价标准的最佳形式是年龄别百分位数,然而,目前我国缺乏胎儿的孕周别体格发育指标百分位数评价标准,影响了胎儿宫内生长发育水平的准确评价,本研究拟建立陕西省正常单胎妊娠孕妇胎儿体格发育指标百分位数参考标准。方法:以陕西省西安、汉中、延安5所大型综合医院超声科或妇产科超声室为数据采集点,选择2010-01-01到2010-12-31间进行常规孕期检查的正常单胎妊娠胎儿的超声测量数据,随机抽取一次测量结果,共收集到6832个单胎正常妊娠胎儿的超声测量数据。采用三次样条法对陕西省孕16-41周正常单胎妊娠胎儿的双顶径、腹围、股骨长百分位数进行拟合。结果:三次样条拟合胎儿的双顶径、腹围、股骨长百分位数,各百分位数的决定系数均在0.95以上,均方差均在各指标重复测量的容许误差内,拟合结果满意。计算出了胎儿的孕周别双顶径、腹围、股骨长的P3、P10、P25、P50、P75、P90、P97百分位数。结论:三次样条兼顾了曲线拟合中的拟合优度和光滑度,能更好的实现曲线拟合的目的。所建立的孕周别胎儿体格发育指标百分位数符合胎儿宫内生长发育规律,为胎儿宫内生长发育的准确评价提供了科学、准确的评价工具,可用于产科临床和研究工作中。
Purpose: The best form of evaluation criteria for growth and development is the age-percentile percentile. However, at present, the evaluation standard of percentile of gestational age without gestational age in our country affects the accurate evaluation of intrauterine growth and development, This study intends to establish Shaanxi normal singleton pregnancy fetus physical development index percentile reference standard. Methods: The data of the ultrasound department or obstetrics and gynecology department in 5 large general hospitals in Xi’an, Hanzhong and Yan’an of Shaanxi Province were collected as normal data, and the normal singleton pregnancies were selected from 2010-01-01 to 2010-12-31 for routine pregnancy test Fetal ultrasound measurements, a random selection of measurement results, a total of 6,832 single-fetus normal fetus fetus ultrasound measurements were collected. Cubic spline method was used to fit the biparietal diameter, abdominal circumference and femur long percentile of normal singleton fetus fetus aged 16-41 weeks in Shaanxi province. Results: The coefficients of determination for the biparietal diameter, abdominal circumference and femur length of the fetuses fitted with the cubic spline were all above 0.95, and the mean square error was within the allowable error of repeated measurement of each index Satisfied with the results. We calculated the gestational age of the fetus did not biparietal diameter, abdominal circumference, femur length P3, P10, P25, P50, P75, P90, P97 percentile. Conclusion: The cubic spline takes into account the goodness of fit and the smoothness in the curve fitting, which can better achieve the purpose of curve fitting. The established gestational age fetus physical development index percentiles in line with intrauterine growth and development rules for the accurate evaluation of intrauterine growth and development provides a scientific and accurate evaluation tool that can be used in obstetrical clinical and research work.