胎儿脐静脉穿刺术在产前诊断中的临床价值  

Application value of ultrasoundguided puncture of fetal umbilical vein in prenatal diagnosis

作　　者：刘虹[1] 苏建芬 吴忠琴[1] 姜科琴 方有珍[1] 

机构地区：[1]贵阳市妇幼保健院,贵州贵阳550003

出　　处：《中国妇幼健康研究》2009年第5期530-532,共3页Chinese Journal of Woman and Child Health Research

基　　金：贵阳市2006年科技计划资助项目[筑科农（2006）第38号文件第1项];贵阳市2007年创新创业资助项目（第1号）

摘　　要：目的 探讨超声引导下胎儿脐静脉穿刺术在产前诊断中的临床价值。方法 采用经腹超声引导的方法，对72例中晚期孕妇的胎儿进行脐静脉穿刺术，通过对胎儿脐血染色体培养，了解胎儿畸形与染色体异常的相关性及胎儿脐静脉穿刺术的安全性。结果 ①72例孕妇中，经超声检查阳性（提示胎儿形态结构异常）者51例，超声检查阴性（未提示胎儿形态结构异常）者21例。穿刺成功61例，穿刺成功率84.72%；②穿刺并发症中：穿刺点出血6例，占8.33%；胎儿心动过缓1例，占1.39%；短暂性宫缩1例，占1.39%；未见胎膜早破、早产、宫内感染及胎儿死亡等并发症；③胎儿畸形与胎儿染色体异常的发生率呈正相关（r=0.572，P〈0.01）。结论 超声引导下胎儿脐静脉穿刺术用于产前诊断可准确地了解胎儿染色体异常情况，其安全可靠，具有较高的临床应用价值。Objective To evaluate value of ultrasoundguided puncture of fetal umbilical vein in prenatal diagnosis. Methods Under direction of transabdominal ultrasonography, 72 pregnant women in middle or late pregnancy were performed on puncture of fetal umbilical vein. The fetal umbilical blood samples taken were cultured for chromosome examination in order to investigate not only relationship between fetal malformation and chromosome abnormalities but also safety of fetal umbilical vein puncture. Results ① Among 72 pregnant women, 52 pregnant women had positive ultrasonography results （who had fetal morphological or structural abnormalities） and 21 pregnant women had nagative results. 61 pregnant women were successfully punctured, and 11 pregnant women failed, the success rate of puncture was 84.72%; ②Puncture complications included： 6 cases of bleeding in the puncture point （8.33%）, 1 case of fetal bradycardia （1.39%） and 1 case of transient uterine contraction（1.39%）. No premature rupture of membranes, premature delivery, intrauterine infection and fetal death and other complications occurred; ③Fetal malformation was positively correlated with fetal chromosome abnormality （r=0.572, P〈0.01）. Conclusion Ultrasoundguided umbilical vein puncture used in prenatal diagnosis can accurately identify those fetal chromosome abnormalities, and has high clinical application value because of its high safety and reliability.

关 键 词：胎儿 脐血 产前诊断 超声 

分 类 号：R714.5[医药卫生—妇产科学]