2018 年第 3 期 第 13 卷

连续顺序追踪超声法检测胎儿骨骼肢体畸形的临床应用效果

The value of sequential tracking ultrasound in detection of fetal skeletal limb deformities

作者：王静王晓燕王巍

英文作者：

单位：100015北京和睦家医院超声科（王静）；100038首都医科大学附属北京世纪坛医院超声科（王晓燕）；100048北京，解放军总医院第一附属医院超声科（王巍）

英文单位：

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• 摘要：

• 目的    探讨连续顺序追踪超声法检测胎儿骨骼肢体畸形应用效果。方法    采用随机抽样与回顾性研究方法，收集2015年8月到2017年5月在北京和睦家医院行早孕期(11～13+6周)超声检查的2 100例孕妇的临床资料。所有患者均给予了连续顺序追踪超声法与传统超声法检测，记录超声与随访结果。结果    在2 100例孕妇中，经产后确诊胎儿骨骼肢体畸形30例（1.4%），平均头臀长为（6.9±1.2）cm、颈部透明层为（5.0±1.0）mm。连续顺序追踪超声法肢体缺失、致死性骨发育不良、先天性马蹄内翻足的检出率高于传统超声法［14/14比8/14、4/4比1/4、5/6比1/6］，差异有统计学意义(P<0.05)，而手指畸形的检出率2组差异无统计学意义(P>0.05)。连续顺序追踪超声法骨骼肢体畸形的诊断敏感度与特异度分别为86.7%和100.0%，传统超声法分别为40.0%和100.0%，连续顺序追踪超声法的诊断敏感度高于传统超声法，差异有统计学意义(P<0.05)。结论    连续顺序追踪超声法检测胎儿骨骼肢体畸形的效果比较好，能在早期及时、准确发现骨骼肢体畸形胎儿，提高诊断效果。

• Objective    To explore the value of sequential tracking ultrasound in detecting fetal skeletal limb deformities. Methods    Clinical records of 2 100 pregnant women(11-13+6 weeks) who had ultrasound examination in Beijing United Family Hospital from August 2015 to May 2017 were reviewed. Results     of sequential tracking ultrasound and traditional ultrasound examination and follow-up records were analyzed. Results    Thirty（1.4%） fetuses were diagnosed of skeletal limb deformities after birth; the mean crown-rump length was （6.9±1.2）cm; the mean neck transparent layer thickness was （5.0±1.0）mm. Detection rates of limb deficiencies, thanatophoric dysplasia and congenital clubfoot of sequential tracking ultrasound were significantly higher than those of traditional ultrasound［14/14 vs 8/14, 4/4 vs 1/4, 5/6 vs 1/6］(P<0.05); detection rate of finger deformities showed no significant difference between 2 examinations(P>0.05). Diagnostic sensitivity and specificity of sequential tracking ultrasound for skeletal limb deformities were 86.7% and 100.0%, which were significantly higher than those of traditional ultrasound（40.0% and 100.0%）(P<0.05). Conclusions    equential tracking ultrasound is effective and accurate in early diagnosis of fetal limb deformities.