产前B超检查诊断胎儿骨骼肢体畸形的价值分析

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1、产前B超检查诊断胎儿骨骼肢体畸形的价值分析［摘要］目的探❷产前B超检查对胎儿骨骼肢体畸形的诊断价值，以提高对胎儿骨骼肢体畸形的临床检出率。方法回顾性分析2013年12月〜2016年12月温州市中心医院收诊的26例胎儿骨骼肢体畸形的妊娠妇女的临床资料和影像学资料，分析产前B超检查与产后胎儿的临床表现及X线片诊断结果。结果本组26例骨骼肢体畸形胎儿均在引产或分娩后由X线或病理解剖等所证实，其中软骨发育不全20例，成骨发育不全6例，产前B超的检出率分别为85%和100%,对前者的检出率与产后X线相比较，差异有统计学意义。产前B超与产后X线检查综合诊断

2、结果显示：本组26例胎儿中，10例头围＞2SD,14例合并羊水过多，17例羊水指数〉18cm,13例合并胸腔狭小、脊柱形态异常、心脏结构异常等畸形。20例软骨发育异常，其中16例胎儿的股骨长、肱骨长均小于同期孕龄的4SD；3例股骨长小于同期孕龄3SD,且肱骨长小于同期孕龄4SD；1例股骨长小于同期孕龄2SD,且肱骨长小于同期孕龄3SDo结论产前B超检查是诊断胎儿骨骼肢体畸形,降低畸形胎儿出生率的首选方法。临床中可同时结合产后胎儿的临床表现、X线检查及基因检测来明确诊断结果，以提高临床诊断准确率。［关键词］胎儿骨骼肢体畸形；B超；X线片；软骨发育

3、不全；成骨发育不全［中图分类号］R71［文献标识码］A［文章编号］1673-721005-0109-04ThevalueanalysisofprenatalultrasonographyindiagnosisoffetalskeletallimbdeformitiesWUJiel订DONGXueqin2CHENXinxiaolTANGShaohua31.DepartmentofObstetricsandGynecology,WenzhouCentreHospital?ZhejiangProvince,Wenzhou325000,China；2.

4、BUltraRoom,WenzhouCentreHospital,ZhejiangProvince,Wenzhou325000,China；3.ClinicalLaboratory,WenzhouCentreHospital,ZhejiangProvince,Wenzhou325000,China［Abstract］ObjectiveToinvestigatethevalueofprenatalultrasonographyinthediagnosisofskeletallimbdeformities,inordertoimprovethecl

5、inicaldetectionrateofthem.MethodsTheclinicaldataandimagingdataof26pregnantwomenwithfetalskeletaldeformitiesofWenzhouCentreHospitalfromDecember2013toDecember2016wereanalyzedretrospectively.Thentheresultsofprenatalultrasoundexamination,postnatalfetalclinicalmanifestationsandX-

6、raydiagnosiswereanalyzed・Results26caseswithfetallimbdeformitieswereconfirmedbyX-raydiagnosisorpathologicalanatomyandsoonafterinducedlaborordelivery,amongthemtherewere20casesofchondrodysplasia,and6casesofosteogenesisimperfecta.Theprenataldiagnosisrateofprenatalultrasonography

7、forthemrespectivelywas85%and100%.Moreover,comparedwiththedetectionrateoftheformerwiththatofpostpartumX-ray,thedifferencewasstatisticallysignificant・TheresultsofprenatalultrasonographyandpostnatalX-rayfilmwereshowedthat：10caseswithheadcircumference>2SD,14casescomplicatedamnio

8、ticfluid,17caseswithamnioticfluidindex>18cm,13casescomplicatedwithstenosiso