中华超声影像学杂志
中華超聲影像學雜誌
중화초성영상학잡지
CHINESE JOURNAL OF ULTRASONOGRAPHY
2011年
6期
483-486
,共4页
卢庆彬%孟才%高莉洁%宫蕊%孙喜红%王志萍%王金桃%赵仲堂
盧慶彬%孟纔%高莉潔%宮蕊%孫喜紅%王誌萍%王金桃%趙仲堂
로경빈%맹재%고리길%궁예%손희홍%왕지평%왕금도%조중당
超声检查%神经管缺损%筛查
超聲檢查%神經管缺損%篩查
초성검사%신경관결손%사사
Ultrasonography%Neural tube defects%Screening
目的 探讨超声筛查神经管缺陷(neural tube defects,NTDs)及各亚型的应用现状及其效果,为制定适宜的NTDs二级预防模式提供科学依据.方法 选取山东省和山西省八地(市)孕育NTDs胎儿妇女459例,对其孕期超声检查情况进行流行病学调查,分析NTDs及各亚型的确诊情况及其影响因素.结果 ①研究对象超声检查使用率为 98.7%,6例(1.3%)在孕期从未进行超声检查.②超声筛查NTDs总确诊率为 85.9% (389/453),无脑儿、脊柱裂和脑膨出分别为 96.4%、79.6%和 73.8% (P<0.05).NTDs平均确诊时间为 24.0 孕周.其中,无脑儿确诊时间最早,脊柱裂确诊时间最晚,分别为 21.2 孕周和 27.1 孕周,脑膨出为 24.7 孕周(P<0.05).③16孕周前NTDs超声检出率为 14.1%,16～20孕周、20～24孕周、24～28孕周和≥28孕周检出率分别为 49.4%、46.3%、49.2%和 52.1%(P<0.05).医院、妇幼保健院和计划生育部门NTDs超声检出率分别为 46.4%,52.0%和 28.1% (P<0.05).二维超声和三维超声NTDs检出率分别为 41.3%和 83.3% (P>0.05).结论 各医疗机构和不同孕期NTDs及各亚型超声检出率均较低.相关卫生部门应采取措施进一步提高超声检查使用率,提高NTDs超声检出率,重点做好基层医疗机构的产前超声筛查,以更好地发挥超声检查在NTDs二级预防中的重要作用.
目的 探討超聲篩查神經管缺陷(neural tube defects,NTDs)及各亞型的應用現狀及其效果,為製定適宜的NTDs二級預防模式提供科學依據.方法 選取山東省和山西省八地(市)孕育NTDs胎兒婦女459例,對其孕期超聲檢查情況進行流行病學調查,分析NTDs及各亞型的確診情況及其影響因素.結果 ①研究對象超聲檢查使用率為 98.7%,6例(1.3%)在孕期從未進行超聲檢查.②超聲篩查NTDs總確診率為 85.9% (389/453),無腦兒、脊柱裂和腦膨齣分彆為 96.4%、79.6%和 73.8% (P<0.05).NTDs平均確診時間為 24.0 孕週.其中,無腦兒確診時間最早,脊柱裂確診時間最晚,分彆為 21.2 孕週和 27.1 孕週,腦膨齣為 24.7 孕週(P<0.05).③16孕週前NTDs超聲檢齣率為 14.1%,16～20孕週、20～24孕週、24～28孕週和≥28孕週檢齣率分彆為 49.4%、46.3%、49.2%和 52.1%(P<0.05).醫院、婦幼保健院和計劃生育部門NTDs超聲檢齣率分彆為 46.4%,52.0%和 28.1% (P<0.05).二維超聲和三維超聲NTDs檢齣率分彆為 41.3%和 83.3% (P>0.05).結論 各醫療機構和不同孕期NTDs及各亞型超聲檢齣率均較低.相關衛生部門應採取措施進一步提高超聲檢查使用率,提高NTDs超聲檢齣率,重點做好基層醫療機構的產前超聲篩查,以更好地髮揮超聲檢查在NTDs二級預防中的重要作用.
목적 탐토초성사사신경관결함(neural tube defects,NTDs)급각아형적응용현상급기효과,위제정괄의적NTDs이급예방모식제공과학의거.방법 선취산동성화산서성팔지(시)잉육NTDs태인부녀459례,대기잉기초성검사정황진행류행병학조사,분석NTDs급각아형적학진정황급기영향인소.결과 ①연구대상초성검사사용솔위 98.7%,6례(1.3%)재잉기종미진행초성검사.②초성사사NTDs총학진솔위 85.9% (389/453),무뇌인、척주렬화뇌팽출분별위 96.4%、79.6%화 73.8% (P<0.05).NTDs평균학진시간위 24.0 잉주.기중,무뇌인학진시간최조,척주렬학진시간최만,분별위 21.2 잉주화 27.1 잉주,뇌팽출위 24.7 잉주(P<0.05).③16잉주전NTDs초성검출솔위 14.1%,16～20잉주、20～24잉주、24～28잉주화≥28잉주검출솔분별위 49.4%、46.3%、49.2%화 52.1%(P<0.05).의원、부유보건원화계화생육부문NTDs초성검출솔분별위 46.4%,52.0%화 28.1% (P<0.05).이유초성화삼유초성NTDs검출솔분별위 41.3%화 83.3% (P>0.05).결론 각의료궤구화불동잉기NTDs급각아형초성검출솔균교저.상관위생부문응채취조시진일보제고초성검사사용솔,제고NTDs초성검출솔,중점주호기층의료궤구적산전초성사사,이경호지발휘초성검사재NTDs이급예방중적중요작용.
Objective To explore the utilization and effectiveness of ultrasound screening for neural tube defects (NTDs),so that to provide scientific evidences for the secondary prevention of NTDs.MethodsFour hundred and fifty-nine women who delivered or gestated NTDs babies or fetuses were randomly selected from Shandong Province and Shanxi Province,and the related information was collected with structured questionnaire by trained interviewers.Results Of the 459 cases,the ultrasonography utilization rate was 98.7%,and 6 cases (1.3%) never took examinations by ultrasonography during the whole pregnancy period.The total diagnosis rate of ultrasound screening for NTDs was 85.9%,and those of anencephalus,spina bifida and encephalocele were 96.4%,79.6% and 73.8% respectively (P<0.05).The average diagnosis week of NTDs was 24.0 and those of anencephalus,spina bifida and encephalocele were 21.2,27.1 and 24.7 respectively (P<0.05).The detection rates of NTDs before 16 weeks,16-20 weeks,20-24 weeks,24-28 weeks and after 28 weeks were 14.1%,49.4%,46.3%,49.2% and 52.1% respectively (P<0.05).The detection rates of NTDs in hospitals,maternal and child care service centers and family planning centers were 46.4%,52.0% and 28.1% respectively (P<0.05).The detection rate of NTDs by two-dimensional ultrasound equipment was 41.3% and 83.3% by three-dimensional ultrasound equipment (P>0.05).Conclusions The detection rates of NTDs and the subtypes by ultrasonography are low at different pregnant periods and in different medical institutions.It is important to increase the utilization rate of ultrasound screening by pregnant women and improve the NTDs diagnostic level of primary health care institutions,so that to improve the efficacy of secondary prevention strategy for NTDs in China.
