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目的探讨超声筛查在诊断早孕期胎儿严重结构畸形中的价值。方法运用超声对6382例孕11~13~(+6)w双胎胎儿多切面扫查,主要包括:胎儿矢状切面、颈部正中矢状面、颅脑切面、胸部切面、腹部切面、膀胱切面、上肢和下肢切面。结果超声筛查6382例双胎胎儿。共诊断异常胎儿161例,分别为:NT增厚伴淋巴管囊肿40例,露脑畸形2例,全前脑11例,单腔心7例,巨膀胱9例,脐膨出13例,脑膨出15例,脊柱裂5例,内脏外翻32例,联体双胎5例,肢体异常2例。单纯性NT增厚20例进行羊水穿刺染色体,核型检查结果11例正常,9例染色体异常,分别为:21-三体综合征6例、1例Turner综合征、2例染色体微缺。结论早孕期超声筛查,可筛查多种致死性严重双胎胎儿畸形,可及早阻止孕妇继续妊娠所带来的伤害,具有极重要的超声价值及临床意义。
Objective To investigate the value of ultrasound screening in the diagnosis of severe fetal structural abnormalities in early pregnancy. Methods A total of 6382 cases of 11 ~ 13 ~ (+6) w twin fetuses were scanned by multi-slice sonography, including fetal sagittal plane, median sagittal plane, craniocerebral section, thoracic section, abdominal section, Section, upper and lower limb section. Results Ultrasound screening 6382 cases of twin fetuses. A total of 161 cases of abnormal fetus were diagnosed: NT thickening with lymphatic cyst in 40 cases, dendritic malformation in 2 cases, total forebrain in 11 cases, single-chamber heart in 7 cases, giant bladder in 9 cases, omphalocele in 13 cases, brain 15 cases of bulging, spina bifida in 5 cases, visceral valgus in 32 cases, conjoined twins in 5 cases, 2 cases of limb abnormalities. Simple NT thickening of 20 cases of amniocentesis chromosomes, karyotype examination results in 11 cases of normal, 9 cases of chromosomal abnormalities were: 21 trisomy syndrome in 6 cases, 1 case of Turner syndrome, 2 cases of chromosomal edema. Conclusion Ultrasound screening in early pregnancy can screen a variety of fatal twin fetal malformations, early termination of pregnancy can prevent the harm caused by pregnancy, has a very important ultrasound value and clinical significance.