产前超声诊断胎儿先天性膈疝合并畸形的临床价值  

Application value of prenatal ultrasound in diagnosis of fetal congenital diaphragmatic hernia and its malformation

作　　者：刘蓉[1] 董菊芳[1] 段文姣[1] LIU Rong;DONG Jufang;DUAN Wenjiao(Department of Ultrasound,Yichang Central People＇s Hospital,Hubei 443003,China)

机构地区：[1]湖北省宜昌市中心人民医院超声科,443003

出　　处：《临床超声医学杂志》2018年第11期772-774,共3页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨产前超声诊断胎儿先天性膈疝及合并畸形的临床价值。方法选取我院确诊的先天性膈疝胎儿75例为病例组,与病例组相同孕周的正常胎儿40例作为正常对照组,回顾性分析病例组胎儿超声表现及其合并畸形情况,测量其健侧肺的肺-头围比(LHR),并比较两组大脑中动脉峰值流速、博动指数、阻力指数和脐动脉收缩末期与舒张末期血流峰值比值(S/D)。结果病例组75例胎儿中,左侧膈疝68例,右侧膈疝7例;单纯性膈疝40例,膈疝合并其他畸形35例,其中合并心血管系统畸形最常见,其次是神经系统、泌尿系统及骨骼系统等。病例组胎儿LHR>1.6者33例,合并其他畸形13例;LHR<1.0者20例,合并其他畸形14例;LHR在1.0～1.6者22例,合并其他畸形8例。病例组大脑中动脉峰值流速为(29.03±0.22)cm/s,低于正常对照组(42.11±0.17)cm/s,差异有统计学意义(P<0.001);两组大脑中动脉搏动指数、阻力指数和胎心率、脐动脉S/D值比较,差异均无统计学意义。结论产前超声可以准确诊断先天性膈疝及其合并畸形类型,了解膈疝胎儿健侧肺的LHR及大脑中动脉血流情况,可为膈疝胎儿产前管理及生后干预提供更多的参考信息。Objective To explore the clinical value of prenatal ultrasound in the diagnosis of fetal congenitaldiaphragmatic hernia （CDH）and its malformation.Methods Seventy-five cases of CDH confirmed in our hospital were selectedas CDH group, and 40 age -matched normal fetus were selected as normal control group.The ultrasonic manifestations and itsmalformation in CDH group were retrospectively analyzed. The lung-to-head ratio（LHR）and fetal middle cerebral artery werecompared between the two groups.Results In 75 cases,68 located on the left and7 located on the right.There were40 cases with CDH only, 35 cases combined with other malformations, including cardiovascular system malformation, nervousmalformation, urogenital system malformation, skeletal system malformation, and etc..33 cases showed LHR 跃1.6, 13 cases ofthem combined with other malformation.20 cases showed LHR约1.0, 14 cases of them combined with other malformation.22 casesshowed LHR from 1.0 to 1.6, 8 cases of them combined with other malformation.Middle cerebral artery flow velocity wassignificantly lower in CDH group than that in normal control group咱 （29.03依0.22） cm/s vs.（42.11依0.17） cm/s, P〈0.001暂.However, there were no significant difference of PI, RI, fetal heart rate and umbilical S/D respectively.Conclusion CDH andits malformation type can be accurately diagnosed by prenatal ultrasound.LHR and middle cerebral artery flow of CDH may providemore information for prenatal management and postpartum intervention.

关 键 词：超声检查 先天性膈疝 胎儿 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.53[医药卫生—诊断学]