血栓性单脐动脉与差异性脐动脉的超声特征及预后  

Ultrasonographic Features and Prognosis of Umbilical Artery Thrombosis and Discordant Umbilical Artery

作　　者：陈丽萍[1] 何晓琴 郑良楷 李胜利[3] 李盈 钟燕秋 Chen Liping;He Xiaoqin;Zheng Liangkai;Li Shengli;Li Ying;Zhong Yanqiu(Department of Ultrasound Medicine,Women's and Children's Hospital Affiliated to Xiamen University(Xiamen Maternal and Child Health Hospital),Xiamen,Fujian 361000,China;Department of Pathology,Women's and Children's Hospital Affiliated to Xiamen University(Xiamen Maternal and Child Health Hospital),Xiamen,Fujian 361000,China;Department of Ultrasound Medicine,Shenzhen Maternal and Child Health Care Hospital affiliated to Southern Medical University,Shenzhen,Guangdong 518000,China)

机构地区：[1]厦门大学附属妇女儿童医院(厦门市妇幼保健院)超声医学科,福建省厦门市361000 [2]厦门大学附属妇女儿童医院(厦门市妇幼保健院)病理科,福建省厦门市361000 [3]南方医科大学附属深圳市妇幼保健院超声医学科,广东省深圳市518000

出　　处：《中国超声医学杂志》2023年第6期680-683,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 探讨血栓性单脐动脉(UAT)发病原因,UAT和差异性脐动脉(DUA)超声图像特征及其预后。方法 回顾性分析超声检测筛查孕晚期的脐动脉数目减少或内径变细的病例。根据病理结果分为UAT组和DUA组,从超声影像、新生儿情况、胎盘病理、脐带标本、母体妊娠期疾病等方面进行对比分析。结果 18 899个病例中检出UAT 7例、DUA 5例。UAT组胎死宫内1例、新生儿重度窒息2例,DUA病例组预后良好,组间对比具有统计学意义;UAT组内高凝血状态2例、妊娠期糖尿病(GDM)4例,DUA组凝血功能异常4例、GDM 1例,两组间比较无统计学意义;高度螺旋的脐带在两组之间对比无统计学意义;UAT组均出现胎盘灌注异常,DUA组内2例检出了灌注异常,组间对比具有统计学意义。中孕期双侧脐动脉形态及晚孕期是否检出异常回声充填(血栓图像)的两组间对比具有统计学意义。结论 回顾中孕期脐动脉内径差异及晚孕期血栓栓塞的特异度声像图是UAT与DUA的鉴别要点。UAT普遍存在胎盘灌注异常,预后情况较DUA差。Objective To investigate etiology of UAT(Umbilical artery thrombosis),the ultrasonographic features of UAT and DUA(Discordant umbilical artery)and their prognosis.Methods A retrospective study was carried out to screen the cases with reduced number or smaller inner diameter of umbilical artery in the third trimester of pregnancy.According to the pathological results,the cases were divided into UAT group and DUA group.The ultrasonic image,the newborn condition,the placental pathology,the umbilical cord specimen,and the pregnant women's disease were compared and analyzed.Results 7 cases of UAT and 5 cases of DUA was detected in 18899 cases;In the UAT group,1 case died in utero and 2 cases suffered from severe asphyxia of newborn.The prognosis of DUA group was generally good,and there was a statistical difference between the two groups.There were 2 cases of hypercoagulable state and 4 cases of GDM(gestational diabetes mellitus)in UAT Group,4 cases of abnormal coagulation and 1 case of GDM in DUA group.There was no statistical difference between the two groups,and the umbilical cord with high helix had no significant statistical difference between the two groups.Abnormal placental perfusion was observed in the all UAT group,and 2 cases in DUA,there was statistical difference between two groups.There were significant differences between the two groups in the shape of umbilical artery in the second trimester of pregnancy and abnormal echo filling(thrombus image)detection in the third trimester of pregnancy.Conclusions Reviewing the difference of the diameter in umbilical artery in the second trimester of pregnancy and the specific signs of thrombus in the third trimester of pregnancy are the important points of differentiation between UAT and DUA in ultrasound differential diagnosis.Abnormal placental perfusion was observed in the all UAT group,the prognosis of UAT is worse than that of DUA.

关 键 词：脐动脉栓塞 脐动脉血栓 差异性脐动脉 超声检查 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.252[医药卫生—诊断学]