早孕期NT超聲檢查在胎兒畸形篩查中的臨床應(yīng)用價(jià)值探究

袁雪英+曹炎+賴育美

【摘要】 目的：分析早孕期二維彩超胎兒頸項(xiàng)透明層厚度（nuchal translucency，NT）超聲對(duì)胎兒畸形篩查的診斷效果，為產(chǎn)前胎兒排畸篩查工作提供可靠的理論依據(jù)。方法：回顧性選取2015年1月-2016年6月本院接診的孕11～13+6周的孕婦6691例作為研究對(duì)象，其中NT值超過(guò)2.5 mm的有58例，對(duì)全部入選者進(jìn)行引產(chǎn)或隨訪至胎兒出生后，探討孕早期二維NT彩超和孕中期三維超聲檢查對(duì)胎兒排畸篩查的診斷效果和價(jià)值分析。結(jié)果：孕早期NT診斷發(fā)現(xiàn)，胎兒NT值58例異常者中有22例（37.93%）合并胎兒畸形，均選擇引產(chǎn)；36例胎兒NT值異常孕婦在16～18周進(jìn)行羊水穿刺染色體檢測(cè)，發(fā)現(xiàn)染色體異常胎兒12例，均選擇引產(chǎn)；對(duì)其余24例孕婦在孕中期進(jìn)行超聲檢測(cè)發(fā)現(xiàn)胎兒畸形6例（10.34%），均選擇引產(chǎn)。以出生和引產(chǎn)結(jié)果為金標(biāo)準(zhǔn)，隨訪至出生18例孕婦正常分娩出的胎兒在6691例研究對(duì)象中，孕早期陽(yáng)性預(yù)測(cè)值為100%，陰性預(yù)測(cè)值為50.00%，敏感性為61.11%，特異性為100%，準(zhǔn)確率為99.73%。結(jié)論：早孕期NT超聲篩查能夠及早發(fā)現(xiàn)胎兒畸形問(wèn)題，有助于孕婦做出理性的判斷，可降低孕婦身心傷害和經(jīng)濟(jì)損失，加強(qiáng)超聲診斷水準(zhǔn)，有較好的社會(huì)價(jià)值。

【關(guān)鍵詞】 早孕期； NT超聲檢查； 胎兒畸形篩查

Exploration of the Clinical Application Value of NT Ultrasonography in Early Pregnancy Screening for Fetal Malformations/YUAN Xue-ying，CAO Yan，LAI Yu-mei.//Medical Innovation of China，2017，14（12）：134-137

【Abstract】 Objective：To analyze the diagnostic value of fetal nuchal translucency（NT） ultrasonography in the screening of fetal malformations at early pregnancy，and to provide a reliable theoretical basis for antenatal screening.Method：6691 pregnant women aged 11-13+6 weeks admitted to our hospital from January 2015 to June 2016 were retrospectively chosen.Among them，58 fetuses with NT value of more than 2.5 mm were followed up for all the fetuses who were enrolled or born after birth.The diagnostic value and value of two dimensional NT color Doppler ultrasound and three dimensional ultrasound in the second trimester of pregnancy in screening fetal abnormalities.Result：NT diagnosis in early pregnancy，fetal NT value in 58 cases of abnormal in 22 cases （37.93%） with fetal malformation，were selected induction，they all chose induction of labor；36 cases of abnormal fetal NT value were detected by amniocentesis at 16-18 weeks，and chromosome abnormality was found in 12 cases，they all chose induction of labor；the other 24 pregnant women were detected by ultrasound in the second trimester of pregnancy，and there were 6 cases （10.34%），they all chose induction of labor.The gold standard of birth and induced labor，based on the gold standard of birth and induced labor，18 fetuses were followed up to the normal birth of the pregnant women in the study of 6691 cases，the positive predictive value was 100%，the negative predictive value was 50.00%，the sensitivity was 61.11%，specificity was 100%，and the accuracy was 99.73%.Conclusion：NT ultrasound screening in early pregnancy can find out the problem of fetal malformation as early as possible，which is helpful for pregnant women to make rational judgment，and can reduce the physical and mental harm and economic loss of pregnant women，it is of great social value to strengthen the level of ultrasonic diagnosis.