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目的研究Ⅲ级产前超声检查在基层医院的应用。方法将我科室有超声经验的医师送开展III产前超声检查早、经验丰富的三级甲等医院进修Ⅲ级产前超声检查半年,使用VolusonE8彩色多普勒超声诊断仪进行Ⅲ级产前超声检查,对可疑病例进行转诊制度。统计2010年1月至2011年10月Ⅲ级产前超声缺陷胎儿的检出率,并和2008年1月至2009年12月I～Ⅱ级产前超声缺陷胎儿的检出率相比较。结果 2008年1月至2009年12月我院缺陷胎儿的检出率是4.51‰,2010年1月至2011年10月月缺陷胎儿的检出率为13.76‰。自我院2010年开展Ⅲ级产前超声检查以来,2010年1月至2011年10月来我院的4767名孕妇中有3923名愿意在我院接受Ⅲ级产前超声检查,共检出异常病例58例,转诊确诊病例54例,其中多发畸形7例,颅脑神经管畸形5例,颜面畸形7例,心脏异常12例,肺囊腺瘤1例,消化系统畸形2例,泌尿系统畸形6例,肢体发育畸形5例,脊柱裂3例,胸腹水2例,脐带发育异常2例,淋巴管水肿2例。结论基层医院开展Ⅲ级产前超声检查让更多的基层孕妇可以在合适的孕周内享受Ⅲ级产前超声检查,减轻上级医院的门诊压力,并可以大大降低基层出生缺陷率。
Objective To study the application of Ⅲ-level prenatal ultrasound in primary hospitals. Methods The physicians with experience of ultrasound in our department were sent to carry out III prenatal ultrasound examination as early as possible, and the experienced third-class first-class hospitals studied the third-grade prenatal ultrasound for six months. The third-grade prenatal ultrasound was performed with Voluson E8 color Doppler ultrasound. Check, suspicious cases of referral system. The detection rate of fetuses with grade Ⅲ prenatal ultrasound between January 2010 and October 2011 was statistically analyzed and compared with that of fetuses with grade Ⅰ ~ Ⅱ prenatal ultrasound defects between January 2008 and December 2009. Results The detection rate of defective fetuses in our hospital from January 2008 to December 2009 was 4.51 ‰. The detection rate of fetuses with monthly defects from January 2010 to October 2011 was 13.76 ‰. Since our hospital carried out grade Ⅲ prenatal ultrasound in 2010, 3923 of 4767 pregnant women who came to our hospital from January 2010 to October 2011 are willing to undergo grade Ⅲ prenatal ultrasound examination in our hospital, and abnormal cases are detected 58 cases were diagnosed in 54 cases of referral, of which 7 cases of multiple malformations, 5 cases of cranial neural tube defects, facial deformity in 7 cases, 12 cases of cardiac abnormalities, pulmonary cystadenoma in 1 case, digestive system malformations in 2 cases, urinary system deformity 6 cases, 5 cases of limb deformity, spina bifida in 3 cases, pleural effusion in 2 cases, umbilical cord development in 2 cases, lymphatic edema in 2 cases. Conclusions The Ⅲ level prenatal ultrasound examination in primary hospitals allows more grass-roots pregnant women to enjoy Ⅲ-level prenatal ultrasound during the appropriate gestational weeks, relieve the outpatient pressure in higher-level hospitals and greatly reduce the birth defect rate.