上海市各级医院产前B超诊断主要畸形水平分析  

Antenatal Diagnosis of Fetal Malformations by Ultrasonography in the 3-level Hospitals of Shanghai

作　　者：丁瑛[1] 朱丽萍[1] 钱尚萍[1] 

机构地区：[1]上海市第一妇婴保健院,上海市妇女保健所,200040

出　　处：《中华围产医学杂志》2000年第3期149-152,共4页Chinese Journal of Perinatal Medicine

基　　金：上海市卫生系统"百人计划"基金!资助项目培养计划书 编号 98BR0 42

摘　　要：目的　提高产前 B超诊断水平 ,降低畸形儿的出生率。　方法　对 1991年～ 1998年出生的无脑儿、脊柱裂、脑膨出、脑积水、腹裂、联体双胎等畸形进行产前 B超诊断情况回顾性调查 ,其中 40 4例作过一次及一次以上 B超 ,作为此次分析对象 ,共计 B超数为 85 3人次。　结果　各主要畸形中以无脑儿和脑积水的产前 B超确诊率最高 ,分别为 6 8%和 5 1.4% ,而脊柱裂最低为 6 .6 %。一、二、三级接产医院对主要畸形确诊率分别为 7.9%、38.0 %、6 0 .6 % ,三级医院中综合性医院确诊率(42 .9% )又低于专科医院 (75 .7% )。三级医院在 1995年～ 1998年对神经管缺陷的确诊率 (6 8.2 % )显著高于 1991年～ 1994年 (35 .1% )。无脑儿、脑积水和腹裂的 B超确诊率随孕周增大而增高。　结论　产前 B超诊断主要畸形水平随医院级别而上升 ,确诊率与畸形程度、类别、妊娠周数及专业人员的技术水平密切相关。Objective To improve the accuracy of antenatal diagnosis of fetal “major”malformations,so as to decrease birth defects and raise the birth quality. Methods For those 404 cases of anencephaly, spina bifida, ancephalocele, hydrocephalus, gastroschisis and conjoined twins who were borned in 1991～1998 and underwent once or more antenatal ultrasonographic examinations a retrospective study was carried out. Results Among “major” malformations, the highest diagnostic accuracy rate occured in ancephaly and hydrocephalus (68% and 51.4%). The lowest one was spina bifida (6.6%). The diagnostic accuracies of major malformation in primary, secondary and tertiary hospital were 7.9%, 38%, and 60.6% respectively. In tertiary hospitals, the diagnostic accuracy of maternity hospitals (75.5%)was significantly higher than that of general hospitals (42.9%). The diagnostic accuracies for NTD in 1995～1998 in teriary hospitals (68.2%) was significantly higher than that in 1991～1994(35.1%). The diagnostic accuracies of anencephalus, hydrocephalus and gastroschisis correlate positively with the increase of gestational weeks ( P <0.01). Conclusions The antenatal diagnosis accuracy of fetal “major”malformations increases with higher level of hospitals. Tertiary maternity hospitals have higher accuracy rates than tertiary general hospitals. Antenatal diagnosis of anencephaly, hydrocephalus and gastroschisis increases with advancing gestational weeks and technical skill.

关 键 词：围产期医学 畸形 产前诊断 B超 

分 类 号：R714.5[医药卫生—妇产科学]