超声诊断孕早期联体双胎畸形的价值  

The Value of Ultrasound Diagnosis of Conjoined Twins Malformation in Early Pregnancy

作　　者：周浔丹 侯小霞 张文婷 杨芳 安培莉 高新茹 ZHOU Xundan;HOU Xiao-xia;ZHANG Wen-ting;YANG Fang;AN Pei-li;GAO Xin-ru(Center of Ultrasound,Northwest Women and Children′s Hospital,Xi′an 710061,China)

机构地区：[1]西北妇女儿童医院医学超声中心,西安710061

出　　处：《国际生殖健康／计划生育杂志》2020年第3期207-209,I0001,共4页Journal of International Reproductive Health/Family Planning

摘　　要：目的:分析联体双胎的超声图像特点,提高超声诊断联体双胎的准确率。方法:回顾性分析西北妇女儿童医院经超声诊断并随访确诊的16例联体双胎的超声资料,经二维超声观察联体胎儿的连接部位、共用脏器、融合程度,并用彩色多普勒超声观察脐血流以及合并畸形的胎儿心血管情况。结果:16例联体双胎畸形中,双头联合11例(68.75%),其中7例胸腹腔联合、2例胸腹腔+骶尾部脊柱联合、2例仅腹腔联合;并头联合4例(25.00%),其中2例合并胸腹腔联合、2例仅头部联合;臀部联合1例(6.25%)。5例合并其他畸形:2例合并颈部水囊瘤(其中1例双胎儿均合并心脏畸形),1例合并无叶全前脑,1例合并上肢桡骨缺如,1例合并小下颌。结论:对于联体双胎应做到尽早诊断并终止妊娠,彩色多普勒超声能直接显示羊膜腔内联体胎儿的连接部位、共用脏器、融合程度及合并畸形,对判断预后具有重要意义。Objective:To analyze the characteristics of ultrasound images of conjoined twins malformation in early pregnancy,and to improve the accuracy of ultrasound diagnosis of conjoined twin-fetuses.Methods:This is a retrospective analysis of 16 cases of conjoined twin-fetuses diagnosed by ultrasound in Northwest Women and Children′s Hospital and confirmed by follow-up.Two-dimensional ultrasound was used to observe the connection site,organ sharing and fusion degree of conjoined fetuses.Results:In 16 conjoined twins,there were 11 cases(68.75%)of parapagus dicephalus,7 cases of thoracoperitoneal joint,2 cases of thoracoperitoneal and sacrococcygeal joint,and 2 cases of only abdominal joint.In 4 cases(25.00%)of craniopagus,there were 2 cases of combined thoracoperitoneal joint,2 case of head joint;1 case(6.25%)of ischiopagus.Among all the cases,5 cases were combined with other malformations,including 2 cases with neck hydrocyst tumor(1 case twins combined heart malformation),1 case with leafless whole forebrain,1 case with upper limb radial absence,and 1 case with small jaw.Conclusions:For conjoined twin fetuses,diagnosis and termination of pregnancy should be done as soon as possible.Ultrasonography can directly show the position,common organs,degree of fusion and concomitant deformity of the conjoined fetus in the amniotic cavity,which is of great significance for judging the prognosis.

关 键 词：超声检查 产前 妊娠初期 超声检查 多普勒 彩色 产前诊断 双生 联体 

分 类 号：R714.5[医药卫生—妇产科学] R445.1[医药卫生—临床医学]