早孕期超声检查在胎儿先天性畸形筛查中价值分析  

Analysis of the value of early pregnancy ultrasound examination in the screening of fetal congenital malformations

作　　者：邓勇 冷俊 李浩然 DENG Yong;LENG Jun;LI Haoran(Department of Special Examination,Yichun Yuanzhou Modern Hospital,Jiangxi Province,Yichun 336000,China;Department of Clinical Laboratory,Yichun Yuanzhou Modern Hospital,Jiangxi Province,Yichun 336000,China;Department of Clinical Medicine,Yichun Vocational Technical College,Jiangxi Province,Yichun 336000,China)

机构地区：[1]江西省宜春袁州现代医院特检科,江西宜春336000 [2]江西省宜春袁州现代医院检验科,江西宜春336000 [3]宜春职业技术学院医学院临床系,江西宜春336000

出　　处：《中国当代医药》2023年第17期130-133,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202212705)。

摘　　要：目的探究早孕期超声检查在胎儿先天性畸形筛查中的应用价值。方法选择2019年4月至2021年8月于宜春袁州现代医院接受早孕期检查的300名孕妇作为研究对象,所有孕妇均行常规B超及胎儿颈项透明层厚度(NT)超声检查,对所有孕妇进行随访至成功分娩,分析孕妇妊娠结局;将分娩结果作为诊断“金标准”,分析常规B超、NT超声单独及联合检查在胎儿畸形中的诊断价值,并计算单独及联合检查与“金标准”的一致性。结果联合检出在胎儿畸形检出率中均高于常规B超检查及NT超声检查,差异有统计学意义(P<0.05)。联合检查在胎儿畸形诊断中灵敏度、阳性预测值均高于常规B超、NT超声单项检查,准确度、阴性预测值均高于常规B超,差异有统计学意义(P<0.05)。Kappa检验显示:常规B超检查与“金标准”的一致性不佳(Kappa值=0.250,P<0.001);NT超声与“金标准”的一致性尚可(Kappa值=0.728,P<0.001);联合检查与“金标准”的一致性良好(Kappa值=1.000,P<0.001)。结论在早孕期胎儿先天性畸形筛查中应用常规B超联合NT超声检查具有较高的临床应用价值,较好地弥补了单项超声检查的不足,为临床诊疗提供可靠参考,值得推广应用。Objective To explore the application value of early pregnancy ultrasound examination in the screening of fetal congenital malformations.Methods A total of 300 pregnant women who received early pregnancy examination in Yuanzhou Modern Hospital of Yichun from April 2019 to August 2021 were selected as the research objects.All pregnant women underwent routine B-ultrasound and fetal nuchal translucency(NT)ultrasound examination,and all pregnant women were followed up until successful delivery.The delivery results were taken as the diagnostic"gold standard",and the diagnostic value of conventional B ultrasound,NT ultrasound alone and combined examination in fetal malformation was analyzed,and the consistency between single and combined examination and the"gold standard"was calculated.Results The combined detection rate of fetal malformation was higher than that of conventional B ultrasound and NT ultrasound,and the difference was statistically significant(P<0.05).The sensitivity and positive predictive value of combined examination in the diagnosis of fetal malformation were higher than those of conventional B-ultrasound and NT ultrasound alone,and the accuracy and negative predictive value were higher than those of conventional B-ultrasound,and the differences were statistically significant(P<0.05).Kappa test showed that the consistency between conventional B ultrasound examination and the"gold standard"was not good(Kappa value=0.250,P<0.001).The consistency between NT ultrasound and the"gold standard"was good(Kappa value=0.728,P<0.001).The consistency between the combined examination and the"gold standard"was good(Kappa value=1.000,P<0.001).Conclusion The application of routine B ultrasound combined with NT ultrasound in the screening of fetal congenital malformation in early pregnancy has high clinical application value,which makes up for the deficiency of single ultrasound examination,and provides a reliable reference for clinical diagnosis and treatment,which is worthy of promotion and application.

关 键 词：先天性畸形 胎儿 早孕期 超声检查 诊断价值 

分 类 号：R445.1[医药卫生—影像医学与核医学]