胎儿永久性右脐静脉及其合并畸形的产前超声诊断  

Prenatal ultrasound diagnosis of fetal right umbilical vein and its associated malformation

作　　者：汪芷先 林小影[1] 吕海云[1] WANG Zhi-xian LIN Xiao-ying LU Hai-yun(Department of Ultrasoun Maternal and Child Health Care Hospital of Baoan District of Shenzhen City ofGuangdongProvince, Guangdong , Shenzhen, 518000Chin)

机构地区：[1]广东省深圳市宝安区妇幼保健院超声科,广东深圳518000

出　　处：《中国优生与遗传杂志》2017年第10期78-79,38,F0004,共4页Chinese Journal of Birth Health & Heredity

摘　　要：目的探讨胎儿永久性右脐静脉及其合并畸形进行产前超声诊断的临床意义。方法选取2015年5月至2016年5月期间我院接收的20 958例孕中晚期孕妇进行常规超声检查,观察PRUV检出率及其合并畸形的检出率。结果本组孕中晚期超声检查20 958例,发现PRUV胎儿81例,检出率为0.39%(81/20 958)。其中单纯PRUV胎儿62例(776.54%),合并畸形21例(25.93%),其中6例合并一种结构异常;1例合并2种或2种以上畸形,胎儿合并腹腔占位、小脑蚓部缺失、左手发育异常、室间隔缺损;本组27例PRUV胎儿中,有10例接受羊水穿刺行染色体检查,其中9例胎儿染色体检查结果正常,1例合并2种或2种以上畸形胎儿染色体结果为21-三体综合征;62例单纯PRUV胎儿脐动脉血流频谱S/D2.2-3.7,平均3,胎儿羊水深度为4.1-7.5cm,平均5.61cm;7例合并结构异常的PRUV胎儿脐动脉血流频谱S/D3.0-5.2,平均3.8,胎儿羊水深度为4.5-6.8cm,平均5.2cm;20例单纯PRUV胎儿均足月分娩,新生儿5min Apgar评分7-10分,平均9分,出生后查体见外观与超声检查结果相符。7例合并畸形胎儿,1例合并多种畸形胎死宫内,3例引产,3例生后发育良好。结论 PRUV胎儿有特定的超声表现,产前超声检查是早期发现PRUV及合并畸形的首要方法,未合并其他畸形者预后良好。Objective：To investigate the clinical significance of prenatal ultrasound diagnosis of fetal right umbilical vein and its associated malformation. Methods：From May 2015 to May 2016,20 958 cases of middle and late pregnant women received routine ultrasound examination in our hospital. The detection rate of PRUV and the detection rate of combined malformation were observed. Results：20 958 cases of PRUV fetuses were detected by ultrasonography at the middle and late stages of pregnancy,and the detection rate was 0.39%（81/20 958）in 81 cases. Of which 62 cases of simple PRUV（776.54%）,fetal malformation in 21 cases（25.93%）,including 6 patients with an abnormal structure;1 cases with 2 or more than 2 kinds of fetal malformation,with abdominal mass,vermis dysplasia,deletion,left ventricular septal defect;27 cases of fetal PRUV in 10 cases undergoing amniocentesis for chromosome examination,including 9 cases of fetal chromosomal examination was normal,1 cases with 2 or more than 2 kinds of abnormal fetal chromosome results for trisomy 21-syndrome;62 cases of fetal umbilical artery blood flow spectrum of pure PRUV S/D2.2-3.7,the average depth of water 3,sheep fetus is 4.1-7.5 cm,the average 5.61 cm;fetal umbilical artery blood flow spectrum of PRUV S/D3.0-5.2,7 cases with abnormal structure of the average of 3.8,fetal amniotic fluid depth is 4.5-6.8 cm,the average 5.2 cm;20 cases of PRUV fetuses were full-term delivery,neonatal 5 min Apgar score 7-10,An average of 9 points,after birth,the examination showed that the appearance was in accordance with the results of ultrasonography. 7 cases with deformed fetus,1 cases with multiple malformation intrauterine fetal death,3 cases induced labor,3 cases developed well after birth. Conclusion：PRUV fetus has a specific sonographic appearance,prenatal ultrasonography is the first method for early detection of PRUV and associated with malformation.

关 键 词：产前 超声诊断 畸形 永久性 右脐静脉 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]