發(fā)布時(shí)間：2018-09-11 20:44

【摘要】：目的探討二維超聲與四維超聲聯(lián)合應(yīng)用對(duì)胎兒隱性脊柱裂的診斷價(jià)值。方法選擇2013年1月至2015年12月到本院進(jìn)行產(chǎn)前篩查,經(jīng)普通超聲檢查懷疑脊柱發(fā)育異常且不能明確診斷的胎兒的孕婦80例,根據(jù)診斷方法不同將孕婦分為兩組,比較兩組超聲診斷胎兒隱性脊柱裂的效果、超聲影像質(zhì)量、漏診和誤診率等指標(biāo),以評(píng)價(jià)四維超聲的準(zhǔn)確性、安全性和臨床應(yīng)用價(jià)值。結(jié)果二維超聲檢查確診隱性脊柱裂2例,四維超聲檢查確診7例,新生兒出生后隨訪結(jié)果隱性脊柱裂為8例。二維超聲檢查與隨訪結(jié)果一致性比較,Kappa=0.184,兩者診斷一致性較低;四維超聲檢查與隨訪結(jié)果一致性比較,Kappa=0.769,兩者診斷一致性較好。二維超聲診斷胎兒隱性脊柱裂的準(zhǔn)確率為25%,四維超聲診斷胎兒隱性脊柱裂的準(zhǔn)確率為100%,χ2=4.001,P0.05,差異具有統(tǒng)計(jì)學(xué)意義。二維超聲檢出的2例隱性脊柱裂均為孕晚期孕婦,占二維超聲檢出率的100%。四維超聲檢出的3例隱性脊柱裂均為孕中期孕婦,占四維超聲檢出率的37.50%;5例為孕晚期,占四維超聲檢出率的62.50%。結(jié)論超聲檢查是產(chǎn)前篩查胎兒隱性脊柱裂的簡(jiǎn)單有效的首選方法,四維超聲動(dòng)態(tài)檢查可彌補(bǔ)二維超聲檢查的不足而提供清晰、直觀,連續(xù)的動(dòng)態(tài)的聲像圖而提高診斷的準(zhǔn)確性。
[Abstract]:Objective to evaluate the diagnostic value of two-dimensional ultrasound and four-dimensional ultrasound in the diagnosis of fetal recessive spina bifida. Methods from January 2013 to December 2015, 80 pregnant women with suspected spinal dysplasia and undiagnosed fetuses were selected and divided into two groups according to different diagnostic methods. In order to evaluate the accuracy, safety and clinical value of four-dimensional ultrasound, we compared the effect, quality, missed diagnosis and misdiagnosis rate of fetal recessive spina bifida between the two groups. Results 2 cases of occult spina bifida were diagnosed by two dimensional ultrasonography, 7 cases were confirmed by four dimensional ultrasonography, 8 cases were diagnosed as occult spina bifida after birth. The consistency of two dimensional ultrasound examination with follow-up results was 0.184, the diagnostic consistency between them was low, and that between four dimensional ultrasound examination and follow up results was 0.769. the diagnostic consistency between the two methods was good. The accuracy of 2-D ultrasound in diagnosis of fetal recessive spina bifida was 25%, and that of four-dimensional ultrasound was 100% (蠂 ~ 2 + 4.001) (P 0.05), the difference was statistically significant. Two cases of recessive spina bifida detected by two dimensional ultrasound were all pregnant women in late pregnancy, accounting for 100% of the detection rate of 2 D ultrasound. The 3 cases of recessive spina bifida detected by four dimensional ultrasound were all pregnant women in the second trimester, and the detection rate of four dimensional ultrasound was 37.50% in 5 cases of late pregnancy and 62.50% of the detection rate of four dimensional ultrasound. Conclusion Ultrasonography is a simple and effective method for prenatal screening of fetal recessive spina bifida. Four-dimensional dynamic ultrasonography can make up for the deficiency of two-dimensional ultrasonography and provide clear, intuitive and continuous dynamic sonography to improve the accuracy of diagnosis.
【作者單位】： 柳州市工人醫(yī)院;
【基金】：廣西衛(wèi)生廳課題(Z2013629)
【分類(lèi)號(hào)】：R445.1;R714.5

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