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目的 :评价超声引导下脐血管穿刺术的安全性,探讨胎儿染色体异常临床高危因素,提高脐血管穿刺对胎儿异常染色体核型的检出率。方法:选取本院超声引导下经腹脐血管穿刺并行染色体检查的孕妇500例,进行染色体核型分析,比较不同产前诊断指征组的异常染色体检出率并进行相关因素分析。结果:穿刺成功率99.6%,胎儿脐血管穿刺的主要并发症为穿刺点出血,共86例,占17.2%;胎心心动过缓10例,占2.0%;胎儿丢失1例,占0.2%。共检出异常染色体核型47例,检出率9.4%。同时合并2种以上产前诊断指征者与胎儿染色体异常存在相关性。结论:脐血染色体核型分析能够为临床上诊断胎儿染色体异常提供可靠依据,脐血管穿刺术是一种安全的产前诊断取材技术。同时合并2种以上产前诊断指征者有必要进行产前诊断。
OBJECTIVE: To evaluate the safety of umbilical vascular puncture guided by ultrasound, to explore the clinical risk factors of fetal chromosomal abnormalities and to improve the detection rate of fetal abnormal chromosomes and karyotypes. Methods: 500 pregnant women undergoing ultrasound-guided percutaneous umbilical cord blood biopsy were selected for chromosome karyotype analysis. The detection rate of abnormal chromosomes in different prenatal diagnosis indications group was compared and the related factors were analyzed. Results: The successful rate of puncture was 99.6%. The main complication of fetal umbilical cord blood puncture was bleeding at puncture point, 86 cases (17.2%), 10 cases of fetal heartbeat (2.0%), 1 fetus lost (0.2%). Abnormal chromosome karyotypes were detected in 47 cases, the detection rate was 9.4%. At the same time, more than two kinds of combined prenatal diagnosis of indications and fetal chromosomal abnormalities exist correlation. Conclusion: Karyotype analysis of cord blood can provide a reliable basis for the diagnosis of fetal chromosomal abnormalities. Umbilical cord blood puncture is a safe technique for prenatal diagnosis. At the same time, more than two kinds of pre-natal diagnosis of indications are necessary for prenatal diagnosis.