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目的探讨产前超声观察肛管声像图对胎儿肛门闭锁的临床意义。方法选择2011年1月至2012年12月在日照市人民医院进行产前超声筛查并生产的孕妇13433例,年龄21~42岁,孕周20~40周;胎儿13600例。对其胎儿肛门进行超声检查,观察胎儿肛管解剖结构多切面超声影像,评价胎儿肛管缺失的方法对筛查胎儿肛门闭锁的准确度。结果胎儿肛管声像图显示率99.2%(13 493/13 600)。其中孕20~27+6周胎儿10 600例,除2例肛门闭锁胎儿外,其余胎儿肛管声像图显示率为99.9%(10598/10600),首次检查胎儿肛管声像图显示率为99.6%(10556/10600),且每例耗时<2min。孕28~40周胎儿3 000例,肛管声像图显示率96.5%(2 895/3 000)。2例胎儿肛门超声检查显示肛管声像图缺失者,引产后尸检证实为胎儿肛门闭锁,超声显示肛管声像图存在的13 493例胎儿产后均排除肛门闭锁畸形。结论产前超声评价胎儿肛管有无缺失的方法简便可靠,可以提高胎儿肛门闭锁的检出率和准确度。
Objective To investigate the clinical significance of prenatal ultrasound in observing anal anus in fetus. Methods From January 2011 to December 2012 in Rizhao City People’s Hospital for prenatal ultrasound screening and the production of pregnant women 13,433 cases, aged 21 to 42 years, gestational age 20 to 40 weeks; fetus 13,600 cases. Fetal anus for ultrasound examination, observation of multiple anatomical fetal anatomy structure of multi-slice ultrasound images to evaluate the method of fetal loss of the anus of the fetus screening for fetal anal atresia accuracy. Results Fetal anal angiography showed 99.2% (13 493/13 600). Including 20 to 27 +6 weeks pregnant fetus 10 600 cases, in addition to 2 cases of anal atresia fetus, the remaining fetal anal canal showed 99.9% (10598/10600), the first examination of fetal anal canal showed that the rate was 99.6% (10556/10600), and each case took less than 2 minutes. Pregnancy 28 to 40 weeks fetus 3 000 cases, the anal canal showed 96.5% (2895/3000). Two cases of fetal anus ultrasonography showed that the absence of anal canal sonography, post-labor autopsy confirmed fetal anus atresia, sonographic evidence of anal canal existence of 13 493 fetuses were excluded after anal atresia. Conclusion The method of prenatal ultrasound to evaluate the absence of fetal anal canal is simple and reliable, which can improve the detection rate and accuracy of fetal anal atresia.