产前超声诊断胎儿先天性多发性关节挛缩症体会及临床意义  

Experience and Clinical Significance of Prenatal Ultrasound in the Diagnosis of Fetal Arthrogryposis Maltiplex Congenita

作　　者：鲍天萍 甄敬华 吴向玲[1] 周伟娜[1] 赵岩[1] 于青[1] Bao Tianping;Zhen Jinghua;Wu Xiangling;Zhou Weina;Zhao Yan;Yu Qing(Department of Ultrasound,Baoding First Central hospital,Baoding,Hebei 071000,China;Department of Outpatient,Baoding First Central hospital,Baoding,Hebei 071000,China)

机构地区：[1]河北省保定市第一中心医院超声科,河北省保定市071000 [2]河北省保定市第一中心医院门诊部,河北省保定市071000

出　　处：《中国超声医学杂志》2023年第2期179-183,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 探讨产前诊断胎儿先天性多发性关节挛缩症的超声表现及临床意义。方法 回顾性分析了39例产前超声诊断为多发性关节挛缩的胎儿,经引产或分娩后证实。对39例胎儿的肢体超声图像特点进行分析,记录合并畸形情况及其相关染色体检查结果,并分析了多发性关节挛缩症状和孕妇体质量及孕妇年龄之间的关系。结果 产前超声诊断的39例多发性关节挛缩症胎儿,其中病变仅累及肢体关节21例;病变除累及关节外还合并内脏或颜面部畸形6例,病变除累及关节外还合并神经系统畸形12例。不同孕妇体质量组(超重-肥胖组和低体质量-正常体质量组)之间的差异有统计学意义(P<0.05),不同孕妇年龄组之间的差异无统计学意义(P>0.05)。结论 产前超声发现胎儿肢体姿势固定,关节僵直,活动减少时,应仔细检查其他关节活动度、周围软组织厚度,以提高多发性关节挛缩症的检出率,指导产前咨询和预后治疗,为优生优育提供保证。Objective To investigate the ultrasonic manifestations and clinical significance of prenatal diagnosis of fetal arthrogryposis maltiplex congenita. Methods Thirty-nine fetuses with arthrogryposis maltiplex congenita diagnosed by prenatal ultrasound and confirmed by induced labor or delivery were retrospectively analyzed. The ultrasonographic characteristics of the limbs of 39 fetuses were analyzed, and the combined malformations and related chromosome examinations results were recorded. The relationship between the symptoms of arthrogryposis maltiplex congenita and maternal age and weight was analyzed. Results Tirty-nine cases with arthrogryposis maltiplex congenita were diagnosed by prenatal ultrasonography, among which 21 cases involved limb joints. There were 6 cases of visceral or facial deformities in addition to joint involvement, and 12 cases of neurological deformities in addition to joint involvement. There were statistically significant differences among different maternal weight groups(overweight-obese group and low-normal weight group)(P<0.05), but there were no statistically significant differences among different maternal age groups(P>0.05). Conclusions When the fetal limb posture is fixed, joint stiffness and activity are found by prenatal ultrasound, the range of motion of other joints and the thickness of surrounding soft tissue should be carefully examined to improve the detection rate of arthrogryposis maltiplex congenita. Prenatal ultrasonic examination can provide a guarantee for healthy birth and healthy education.

关 键 词：产前诊断 胎儿 肢体畸形 关节挛缩症 

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]