超声引导下氯化钾选择性减胎术131例分析

发布时间：2018-01-10 05:07

本文关键词：超声引导下氯化钾选择性减胎术131例分析　出处：《中国医学创新》2017年10期 　论文类型：期刊论文

【摘要】：目的:回顾总结选择性减胎治疗的结局预后,分析选择性减胎术的应用价值。方法:2010年1月-2015年9月本院产前诊断中心接受选择性减胎手术的病例共131例,在彩色多普勒超声诊断仪引导下进行氯化钾(KCl)心内注射减胎。结果:131例减胎病例,孕妇平均年龄(37.12±2.71)岁;其中双胎妊娠69例,三胎及三胎以上妊娠病例62例;12例失访,11例流产。减胎孕周对流产发生率无影响(χ2=1.60,P=0.34);保留胎儿个数对流产率无影响(χ2=0.76,P=0.50)。所有未发生流产病例平均分娩孕周(37.13±2.71)周,减胎手术孕周与保留胎儿个数对于胎儿是否发生34周前早产无影响(P0.05)。在新生儿出生体重方面,保留单胎或保留双胎则对胎儿平均出生体重的有影响(χ2=89.59,P=0.02)。结论:KCl减胎术是一种安全可靠的选择性减胎手术操作,并且随着产前诊断技术的不断提高,对于以胎儿疾病为手术指征的病例,应选择在尽可能早孕期施行减胎手术。对于三胎妊娠以上病例而言,保留单胎的围产结局优于保留双胎。
[Abstract]:Objective: to review the outcome and prognosis of selective fetal reduction therapy. Methods: from January 2010 to September 2015, there were 131 cases of selective fetal reduction in our hospital. Results the mean age of pregnant women was 37.12 卤2.71 years old. Among them, 69 cases of twin pregnancy, 62 cases of three or more pregnancies; There were 11 miscarriages in 12 cases. The incidence of abortion was not affected by pregnancy reduction (蠂 ~ 2 = 1.60) (蠂 ~ 2 = 1.60) or 0.34% (P = 0.34). There was no effect of the number of fetus retained on the abortion rate (蠂 ~ 2 / 0.76). The average gestational week of delivery was 37.13 卤2.71 weeks in all cases without abortion. The gestational weeks of fetal reduction and the number of preserved fetuses had no effect on the preterm delivery before 34 weeks, and the birth weight of the newborns was not affected. The retention of single or twin fetus had an effect on the average birth weight of the fetus (蠂 ~ (2 +) 89.59 ~ (9)) (P < 0.02). Conclusion: KCl is a safe and reliable selective fetal reduction procedure. And with the continuous improvement of prenatal diagnosis technology, for cases with fetal diseases as the indication of surgery, we should choose to take the reduction operation in the early pregnancy period as far as possible, and for the cases with more than three pregnancies. The perinatal outcome of single pregnancy was better than that of twin.
【作者单位】：广州医科大学附属第三医院;
【基金】：国家自然科学基金项目(81671470) 国家公益性行业科研专项项目(201402006) 广东省自然科学基金项目(2016A030313610) 广州市科技计划项目(201604020078)
【分类号】：R714.2;R445.1
【正文快照】： Research of Ultrasound-guided Selective Fetocide in 131 Cases with Multiple Pregnancies/LI Nan,WANG Jia-yan,CHEN Min,et al.//Medical Innovation of China,2017,14(10):001-004根据Hellin法则,多胎妊娠的自然发生率为1∶80n-1,但随着促排卵技术和辅助生殖技术的应用

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