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产前预测胎儿宫内贫血,对指导临床干预、降低围生儿死亡率,提高围生医学质量具有重要意义。传统的产前诊断胎儿溶血性贫血的方法属于有创性检测,增加了妊娠妇女与胎儿的风险。近年来采用二维、三维及彩色多普勒超声产前诊断胎儿贫血取得了较大的进展,研究较多的指标包括胎盘厚度及体积;胎儿大脑中动脉血流峰速(MCA-PSV);胎儿心血管循环;脾动脉峰值流速;游离段脐动脉、脐静脉的内径,脐动脉搏动指数,以及肝内段脐静脉收缩期峰值血流速度;静脉导管峰值流速等。在众多超声指标中,MCA-PSV是敏感度及特异度最高的指标,联合多个指标将提高诊断的准确性。
Prenatal prediction of fetal anemia, to guide clinical intervention, reduce perinatal mortality and improve the quality of perinatal medicine is of great significance. Traditional methods of prenatal diagnosis of fetal hemolytic anemia are invasive tests that increase the risk of pregnant women and fetuses. In recent years, the use of two-dimensional, three-dimensional and color Doppler ultrasound prenatal diagnosis of fetal anemia made great progress, research more indicators, including placental thickness and volume; fetal cerebral artery flow velocity (MCA-PSV); Fetal cardiovascular circulation; Splenic artery peak flow rate; Free segment umbilical artery, the diameter of the umbilical vein, umbilical artery pulsatility index, and intrahepatic umbilical venous systolic peak flow velocity; venous catheter peak flow rate. In many ultrasound indicators, MCA-PSV is the most sensitive and specific index, the combination of multiple indicators will improve the diagnostic accuracy.