CAJ | 학술논문

目的：探讨临床和超声预测巨大儿的敏感指标。方法选择本院2012年5～11月住院分娩单胎的孕妇1037例为研究对象，分娩前3 d测量孕妇宫高、腹围，超声测量胎儿径线包括双顶径（BPD）、股骨长（FL）、头围（HC）、腹围（AC）。以预测体质量与实际体质量绝对误差小于或等于250 g为符合，将宫高＋腹围初筛巨大儿，然后分别计算单个AC、HC、FL、BPD参数的回归公式，分别计算诊断符合率。结果宫高＋AC大于134 cm时，初筛巨大儿诊断指数最高，其ROC曲线下面积为0．895。联合超声胎儿AC ，巨大儿的诊断预测率最高为75．2％；胎儿AC≥37 cm ，巨大儿发生率可达91．7％。结论孕妇宫高＋ AC＜134 cm ，巨大儿可能性不大；宫高＋AC≥134 cm ，联合超声胎儿AC＞36 cm ，特别是AC≥37 cm巨大儿可能性非常大。
목적：탐토림상화초성예측거대인적민감지표。방법선택본원2012년5～11월주원분면단태적잉부1037례위연구대상，분면전3 d측량잉부궁고、복위，초성측량태인경선포괄쌍정경（BPD）、고골장（FL）、두위（HC）、복위（AC）。이예측체질량여실제체질량절대오차소우혹등우250 g위부합，장궁고＋복위초사거대인，연후분별계산단개AC、HC、FL、BPD삼수적회귀공식，분별계산진단부합솔。결과궁고＋AC대우134 cm시，초사거대인진단지수최고，기ROC곡선하면적위0．895。연합초성태인AC ，거대인적진단예측솔최고위75．2％；태인AC≥37 cm ，거대인발생솔가체91．7％。결론잉부궁고＋ AC＜134 cm ，거대인가능성불대；궁고＋AC≥134 cm ，연합초성태인AC＞36 cm ，특별시AC≥37 cm거대인가능성비상대。
Objective To investigate the relativity for weight of macrosomia predicted by ultrasound and clinical measurements . Methods 1 037 subjects who were delivered in May to November 2012 ,in Chongqing Health Center for Women and Children ,were collected and analyzed satistically .The parameters for the comparisons included maternal abdominal circumference (MAC) ,fundal height(FH) ,and fetal diameters measured by ultrasonic imaging such as biparietal diameter (BPD) ,head circumference(HC) ,femur length(FL) ,and abdominal circumference(AC) .The coincidence was calculated with real weights and compared with clinical predic-tions .Results When FH+ MAC 134 cm ,the accuracy of preliminary screening for macrosomia is the highest ,the area under the ROC curve is 0 .895 .Combining with the abdominal circumference(AC) by prenatal ultrasound ,the highest prediction rate of mac-rosomia is 75 .2% .when Fetal AC≥37 cm ,macrosomia incidence rate took 91 .7% .Conclusion Pregnant women with FH+MAC<134 cm ,whose incidence of Macrosomia is low .While if the FH+MAC≥134 cm ,combining with the prenatal ultrasound whose fetal AC>36 cm ,especially ≥37 cm ,the possibility of macrosomia is very high .