B超引导下的脐静脉穿刺术在产前诊断应用中的安全性研究  

Studies on safety of cordocentesis guided by transabdominal ultrasound for prenatal diagnosis

作　　者：廖灿[1] 潘敏[1] 李东至[1] 钟燕芳[1] 魏佳雪[1] 易翠兴[1] 李坚[1] 钟惠珠[1] 

机构地区：[1]广州市妇婴医院优生围产研究所,510180

出　　处：《中华妇产科杂志》2004年第12期813-815,共3页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的　探讨B超引导下的脐静脉穿刺术在产前诊断中的成功率和安全性。方法　回顾性分析 1990年 3月～ 2 0 0 3年 6月对 2 4 0 3例因各种原因在B超引导下的脐静脉穿刺术进行产前诊断的孕妇临床资料 ,观察穿刺手术的成功率和并发症。结果　一次性穿刺成功为 2 36 8例 (98 5 % ) ,二次穿刺成功为 2 384例 (99 2 % )。 75 5 %的孕妇可在 5min内完成穿刺术 ,93 0 %的孕妇在 10min内完成穿刺术。手术并发症包括 :脐带或胎盘渗血 315例 (13 1% ) ,胎儿心动过缓 12 5例 (5 2 % ) ,一次性穿刺失败 35例 (1 5 % ) ,流产 18例 (0 8% ) ,早产 4例 (0 2 % ) ,绒毛膜羊膜炎 2例 (0 1% )。结论　脐静脉穿刺术是一项较为安全而简单易行的产前诊断取材技术。Objective To assess the safety and efficacy of diagnostic cordocentesis during pregnancy Methods During March 1990 to June 2003, 2403 consecutive cordocenteses were performed under transabdominal ultrasound guidance at Guangzhou Women and Children's Hospital The results of each procedure was prospectively collected and subsequently analysed in terms of operational complications and pregnancy outcomes Results Success rate of cordocentesis: totally 2368 procedures (98 5%) were done successfully at the first attempt, and 35(1 5%) required repeated cordocentesis, 16 of which were performed successfully at second attempt Duration of cordocentesis: In 75 5% cases, the procedure was completed in less than 5 min, and in 93 0% cases in less than 10 min Complications: Transient bleeding at puncture site was observed in 315 cases (13 1%), transient fetal bradycardia in 125 cases (5 2%), and chorioamnionitis in 2 cases (0 1%) Pregnancy outcomes: The total fetal loss rate was 0 8% (18 cases of abortions) The rate of premature birth after cordocentesis was 0 2% (4 cases) Conclusion Cordocentesis during pregnancy is a useful, relatively safe, and effective procedure for prenatal diagnosis

关 键 词：脐静脉穿刺 产前诊断 B超引导 穿刺术 穿刺成功 孕妇 并发症 成功率 

分 类 号：R714.5[医药卫生—妇产科学]