摘要
目的 在早孕期畸形胎儿筛查中分析颈后透明层(NT)超声的应用价值。方法 选取2021年3月-2022年3月在本院建档立卡的1974例孕妇为研究对象,所有患者均在早期接受NT超声检查,并以胎儿分娩、手术或尸检病理结果为标准。观察NT超声检查结果及应用价值。结果 1974例孕妇中出现NT增厚27例,经超声诊断出胎儿畸形6例,其中伴有染色体异常5例。超声诊断出早孕期NT增厚、胎儿畸形及合并染色体异常胎儿与NT增厚伴胎儿结构异常总数比较,其畸形灵敏度83.33%(5/6),特异度为98.93%(1947/1968),准确度为98.63%(1947/1974),阴性预测值为99.94%(1968/1969)、阳性预测值22.22%(6/27);对比观察1947例NT超声检查正常胎儿与6例异常胎儿颈后透明层厚度发现,5例检查结果提示异常胎儿颈后透明层厚度显著较高(P<0.05);经NT超声检查异常且染色体核型显示异常的胎儿有5例,以21-三体综合征较为常见,占比60.00%(3/5),对比观察三组研究对象孕周及NT厚度发现,21-三体孕周时间最长,18-三体综合征NT厚度最厚;后续超声随访监测胎儿畸形类型发现,以颜面部鼻骨问题较为常见,其次为心脏畸形,骨骼畸形,颈部淋巴水囊瘤、脐膨出及全身皮肤水肿异常。结论 新生儿生育质量与我国人口质量息息相关,加强对畸形胎儿的防治具有重要意义,在早孕期开展NT超声检查能够提高筛查诊断准确率,为孕妇优生优育提供有力的诊断依据,值得在临床推广运用。
Objective To analyze application value of nuchal translucency(NT)ultrasound in screening fetuses with early pregnancy abnormalities.Methods The study chose 1974 pregnant women filled and registered in our hospital from March 2021 to March 2022 as research subjects,all of whom were examined NT ultrasound at early stage,and observed results and application value of NT ultrasound examination based on standard of pathological results of fetal delivery,surgery,or autopsy.Results Among 1974 pregnant women,27 cases showed NT thickening and 6 cases were diagnosed with fetal malformations,including 5 cases of chromosomal abnormalities.Comparison between ultrasound diagnosis of NT thickening,fetal malformations and combined chromosomal abnormalities in early pregnancy and NT thickening and fetal structural abnormalities showed,sensitivity of 83.33%(5/6),specificity of 98.93%(1947/1968),accuracy of 98.63%(1947/1974),negative predictive value of 99.94%(1968/1969)and positive predictive value of 22.22%(6/27).Comparative observation of 1947 normal fetuses and 6 abnormal fetuses with NT ultrasound showed,thickness of posterior cervical transparent layer was significantly higher in 5 abnormal fetuses(P<0.05).There were 5 fetuses with abnormal NT ultrasound examination and chromosomal karyotype display.Among them,trisomy 21 syndrome was more common,accounting for 60.00%(3/5).Comparison of gestational age and NT thickness of three study groups showed,trisomy 21 had the longest gestational age and trisomy 18 had the thickest NT thickness;subsequent ultrasound followup monitoring of fetal malformation types revealed,facial and nasal bone problems were more common,followed by heart malformations,skeletal malformations,neck lymphangioma,omphalocele and abnormal skin edema throughout the body.Conclusion Birth quality of neonates is closely related to population quality in China and it is of great significance to strengthen prevention and treatment of malformed fetuses.Carry on NT ultrasound examination in early pregnancy can improve accuracy of screening and diagnosis, provide favorable diagnostic basis for eugenics and fertility of pregnant women, which can be further promoted and applied in clinical practice.
作者
鞠晓艳
JU Xiaoyan(Beijing Amcare Women’s and Children's Hospital,Beijing 100089)
出处
《智慧健康》
2023年第18期1-4,13,共5页
Smart Healthcare
关键词
早孕期
NT超声
胎儿畸形
临床价值
Early pregnancy
NT ultrasound
Fetal malformation
Clinical value
