超声引导羊膜腔穿刺术及脐带穿刺术在产前诊断胎儿地中海贫血中的应用  

Clinical Application of Amniocentesis and Fetal Blood Sampling to Prenatal Diagnosis of Mediterranean Anemia

作　　者：张英[1] 黄泳华[2] 冯穗华[2] 

机构地区：[1]江门市中心医院超声室,广东省江门市529071 [2]江门市中心医院产科,广东省江门市529071

出　　处：《中国超声医学杂志》2005年第5期376-378,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨超声引导羊膜腔穿刺术(AC)和脐带穿刺术(FBS)在产前诊断胎儿地中海贫血(MA)中的应用价值。方法将夫妇均为MA基因携带者的58例孕妇按孕周的大小分为两组,16～20孕周38例为AC组,21～36孕周20例为FBS组,分别抽取羊水标本和脐带血标本进行MA基因分析。结果AC组一针成功率为100%,穿刺经胎盘占21%,心动过缓发生率为零,标本母血污染率2.6%;FBS组一针成功率85%,穿刺经胎盘占48%,心动过缓发生率10%,标本送检成功率100%。结论AC操作简便,安全,而FBS虽风险较大,但标本送检成功率高,适用的孕周较长,可弥补AC的不足。AC和FBS在产前诊断MA中均发挥了重要的作用。Objective To investigate the clinical application value of amniocentesis(AC) and fetal blood sampling(FBS) to the prenatal diagnosis of Mediterranean anemia(MA).Methods A total of 58 pregnant women whose husbands and themselves carried MA gene were divided into two groups according to the pregnant weeks:AC group including 38 cases of pregnancy between 16 and 20 weeks,FBS group including 20 cases of pregnancy between 21 and 36 weeks.The amniotic fluid and fetal blood samples were adopted for genetic analysis of MA.Results In AC and FBS groups,the successful rate of the first puncture was 100% and 85%,respectively;the occurrence of puncture through the placenta was 21% and 48%,respectively;the occurrence of brady cardia was 0 and 10%,respectively.In AC group,the contamination of the maternal blood was 2.6%.Conclusions AC is easy and safe to perform,but it is only suitable for second trimester.The FBS is suitable for both the second and third trimesters;the successful rate of fetal blood sample tests is very high.There fore,both AC and FBS are significant in screening for MA and can not be replaced by other methods at present.

关 键 词：羊膜腔穿刺术 地中海贫血 脐带穿刺术 产前诊断 超声引导 胎儿 一针成功率 心动过缓 标本送检 基因携带者 FBS 应用价值 20孕周 基因分析 羊水标本 经胎盘 发生率 MA 血标本 污染率 AC C组 

分 类 号：R714.5[医药卫生—妇产科学] R556.61[医药卫生—临床医学]