超声检查在高龄产妇胎儿出生缺陷中的临床价值及影响因素分析

发布时间：2018-01-30 18:06

本文关键词： 超声检查高龄产妇出生缺陷临床价值影响因素　出处：《山东大学》2017年硕士论文　论文类型：学位论文

【摘要】：研究目的:本研究选取77例出现胎儿出生缺陷的高龄产妇,通过对比最终的妊娠结局和产前超声检查的结果,分析胎儿结构畸形疾病的分布特点和漏诊原因,评价超声检查在高龄产妇胎儿出生缺陷中的临床价值及其影响因素,以期为产前超声筛查出生缺陷工作提供参考依据。研究方法:选取2013年3月至2015年6月期间在临沂市人民医院进行孕检并最终确定为出生缺陷的77例高龄产妇为研究对象。采用美国GE公司生产的Voluson-730、Voluson E8,飞利浦公司生产的Philips IU22彩色多普勒超声诊断仪进行产前检查。利用EXCEL2007建立数据库,应用SPSS20.0统计分析软件进行数据整理和分析。研究结果:1.本研究最终纳入3274例高龄产妇,通过对其进行系统的超声检查并追踪其最终的妊娠结局,共有77例先天性出生缺陷胎儿,出生缺陷率为2.35%,单发畸形54例,占70.13%;多发畸形23例,占29.87%。2.在各类型的出生缺陷中,先天性出生缺陷胎儿中主要为心血管畸形,共18例(占23.37%);多系统畸形有17例(占22.07%);中枢神经系统畸形有11例(占14.28%);综合征有10例(占12.98%);裂,有6例(占7.79%);泌尿生殖系统畸形4例(占5.19%);肌肉骨骼系统畸形4例(占5.19%);呼吸系统畸形3例(占3.89%);胃肠系统畸形3例(占3.89%);眼部及耳畸形1例(占1.29%)。综合征所占比例上升。3.在77例确诊为出生缺陷的胎儿中产前超声检出67例,诊断符合率为87.01%;漏诊10例,漏诊率为12.99%。4.在各类型出生缺陷的漏诊构成比中,颌面部畸形和骨骼系统畸形的漏诊率较高,分别为23.08%和16.67%。而中枢神经系统畸形、消化系统畸形的漏诊率均较低。5.孕检次数、胎龄、胎儿数、医师工作年限这四项因素的不同水平间的超声诊断符合率具有统计学差异(P0.05),单一畸形及多发畸形没有差异。研究结论:1.本研究结果显示高龄产妇出生缺陷中心血管畸形排在首位,依次是多系统畸形,中枢神经系统畸形;综合征,裂,泌尿生殖系统畸形。2.影响超声诊断胎儿出生缺陷符合率的因素较多,主要包括产前孕检次数、胎龄、胎儿数以及医生工作年限。
[Abstract]:Objective: to analyze the distribution of fetal structural malformation and the causes of missed diagnosis by comparing the final outcome of pregnancy and the results of prenatal ultrasound in 77 elderly women with fetal birth defects. Objective: to evaluate the clinical value and influencing factors of ultrasound examination in fetal birth defects in elderly women. In order to provide a reference for prenatal ultrasound screening of birth defects. Research methods:. From March 2013 to June 2015, 77 pregnant women with birth defects were selected for pregnancy examination in Linyi people's Hospital. Volu produced by GE Company of USA was used as the research object. Son-730. Voluson E8, Philips IU22 color Doppler ultrasound diagnostic instrument produced by Philips, was used for prenatal examination. The database was established by EXCEL2007. SPSS20.0 statistical analysis software was used to collect and analyze the data. The result of the study was: 1.The study included 3274 elderly puerperas. A total of 77 cases of congenital birth defects were detected by systematic ultrasonic examination and their final pregnancy outcome was followed up. The birth defect rate was 2.35 and the single malformation was 54 cases (70.13%). There were 23 cases of multiple malformations (29.87%). Among all kinds of birth defects, 18 cases (23.3737%) were mainly cardiovascular malformation. There were 17 cases of multi-system malformation (22.07%). There were 11 cases of central nervous system malformation (14.28%). There were 10 cases of syndrome (12.98%). Cleft, 6 cases (7.79%); 4 cases of genitourinary malformation (5.19%); There were 4 cases of musculoskeletal system malformation (5.19%). 3 cases of respiratory malformation (3.89%); 3 cases of gastrointestinal malformation (3.89%); One case (1.29%) of eye and ear malformation (1.29%). The proportion of syndrome increased. Among 77 cases of fetus diagnosed as birth defect, 67 cases were detected by prenatal ultrasound, and the diagnostic coincidence rate was 87.01%. The missed diagnosis rate was 12.99% in 10 cases. The missed diagnosis rate of maxillofacial malformations and skeletal system deformities was higher than that of different types of birth defects. The missed diagnosis rate of central nervous system malformation and digestive system malformation were all lower. 5. Pregnancy check times, gestational age and the number of fetuses. The coincidence rate of ultrasound diagnosis among these four factors was statistically different (P 0.05). There was no difference between single malformation and multiple malformation. Conclusion: 1.The results showed that the central vascular malformation of birth defects in the elderly women ranked first, followed by multi-system malformation and central nervous system malformation. There are many factors affecting the coincidence rate of ultrasound diagnosis of fetal birth defects, including the number of prenatal pregnancy, gestational age, the number of fetuses and the working years of doctors.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.1;R714.5

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