脐带穿刺术在产前诊断中的应用及临床分析  

Application and clinical analysis on cordocentesis in prenatal diagnosis

作　　者：刘晓军[1] 丛林[1] 袁静[1] 方慧琴[1] 赵保静[1] 

机构地区：[1]安徽医科大学第一附属医院妇产科,安徽合肥230022

出　　处：《中国妇幼保健》2011年第9期1390-1392,共3页Maternal and Child Health Care of China

基　　金：安徽省2008年科技攻关项目〔08010302181〕;安徽省临床医学应用技术项目〔2008A003〕

摘　　要：目的:探讨B超引导下的脐带穿刺术在产前诊断中的应用价值。方法:对安徽医科大学第一附属医院2007年1月～2009年12月因产前诊断需要做脐带穿刺、行胎儿染色体核型分析的93例孕妇的临床资料进行回顾性分析,观察穿刺手术及细胞培养的成功率、手术并发证及妊娠结局。结果:一次穿刺成功率达到96.77%,失败病例均发生在开展此技术的初期阶段,近1年穿刺成功率达100%,细胞培养成功率(染色体核型分析报告)达100%,检出异常核型13例(13.98%),其中21-三体的发生率最高,发生感染、流产、早产及胎死宫内等严重并发证0例,发生胎儿心动过缓7例(7.53%),经处理3～5 min后恢复正常,脐带及胎盘穿刺点渗血时间>30 s者15例(16.13%),1 h后复查B超胎儿正常。妊娠结局除发现异常需要引产外,余随访至分娩新生儿预后均良好。结论:B超引导下的脐带穿刺术是一项成功率高、安全、可靠的产前诊断方法,在临床上有着广泛的运用前景。Objective：To explore the application value of cordocentesis under type B ultrasound guidance in prenatal diagnosis. Methods：The clinical data of 93 pregnant women who had received cordocentesis and fetal chromosomal karyotype analysis because of prenatal diagnosis in the hospital from January 2007 to December 2009 were analyzed retrospectively;the success rates of cordocentesis and cell culture,complications of surgery and pregnancy outcomes were observed. Results：The success rate of first puncture was 96.77%,the failed cases occurred in the early stages of this technology,the success rate was 100% in the past year.The success rate of cell culture（the chromosomal karyotype analysis report） reached 100%.13 cases（13.98%） with abnormal karyotypes were found,the incidence of trisomy 21 was the highest.No complications such as infection,abortion,premature delivery and intrauterine fetal death occurred,7 cases（7.53%） were found with fetal bradycardia,then they returned to normal after treatment for 3～5 minutes,the bleeding times of umbilical cord and placenta puncture sites of 15 cases were more than 30 seconds,accounting for 16.13%,the fetuses were normal after one hour when the cases were reexamined by type B ultrasound;the cases were followed up till delivery,the prognosis of neonates was good except some abnormal cases needing induced labor. Conclusion：Cordocentesis under type B ultrasound guidance is a safe and reliable prenatal diagnosis method with high success rate,which has broad application prospect in clinic.

关 键 词：脐带 穿刺术 产前诊断 

分 类 号：R714.55[医药卫生—妇产科学]