CAJ | 학술논문

目的探讨产前经腹超声联合前后囟声窗获得胎儿颅脑正中矢状切面的可行性.方法 2012年4月2日至8月10日,10例因胎儿畸形或母亲因素引产或流产的死亡胎儿进行颅脑超声检查,以前囟、矢状缝、后囟及枕骨大孔为声窗.2012年7月5日到8月25日间,共有200例孕妇在妊娠22～24周接受系统产前超声筛查.采用经腹超声,以前囟、矢状缝及后囟为声窗采集胎儿颅脑正中矢状切面.计算各声窗获得颅脑正中矢状切面的成功率,数据比较采用x2检验. 结果 (1)10例引产或流产出的胎儿经前囟、矢状缝、后囟声窗均成功获得颅脑正中矢状切面.(2)产前超声胎儿颅脑正中矢状切面的获得情况:200例胎儿单独经后囟声窗获得颅脑正中矢状切面的成功率为76.0％(152/200),高于单独经前囟声窗的成功率[59.5％(119/200)],差异有统计学意义(x2=12.5,P＜0.01).联合采用前后囟声窗获得胎儿颅脑正中矢状切面的成功率为95.5％(191/200),高于单独经前囟或单独经后囟的成功率,差异均有统计学意义(x2分别为74.3和31.1,P均＜0.01).头位胎儿单独经后囟声窗获得颅脑正中矢状切面的成功率为63.7％(65/102),高于单独经前囟声窗的成功率[37.3％(38/102)],差异有统计学意义(x2=14.3,P＜0.01).非头位胎儿单独经后囟声窗获得颅脑正中矢状切面的成功率为88.8％(87/98),与单独经前囟声窗的成功率[82.7％(81/98)]差异无统计学意义(x2=1.5,P＞0.05).头位胎儿经前后囟声窗皆获得颅脑正中矢状切面的成功率为9.8％(10/102),低于非头位胎儿[71.4％(70/98)],差异有统计学意义(x2=79.1,P＜0.01). 结论后囟声窗获得胎儿颅脑正中矢状切面的成功率高于前囟,联合采用前、后囟声窗可以提高获得该切面的成功率.
목적 탐토산전경복초성연합전후신성창획득태인로뇌정중시상절면적가행성.방법 2012년4월2일지8월10일,10례인태인기형혹모친인소인산혹유산적사망태인진행로뇌초성검사,이전신、시상봉、후신급침골대공위성창.2012년7월5일도8월25일간,공유200례잉부재임신22～24주접수계통산전초성사사.채용경복초성,이전신、시상봉급후신위성창채집태인로뇌정중시상절면.계산각성창획득로뇌정중시상절면적성공솔,수거비교채용x2검험. 결과 (1)10례인산혹유산출적태인경전신、시상봉、후신성창균성공획득로뇌정중시상절면.(2)산전초성태인로뇌정중시상절면적획득정황:200례태인단독경후신성창획득로뇌정중시상절면적성공솔위76.0％(152/200),고우단독경전신성창적성공솔[59.5％(119/200)],차이유통계학의의(x2=12.5,P＜0.01).연합채용전후신성창획득태인로뇌정중시상절면적성공솔위95.5％(191/200),고우단독경전신혹단독경후신적성공솔,차이균유통계학의의(x2분별위74.3화31.1,P균＜0.01).두위태인단독경후신성창획득로뇌정중시상절면적성공솔위63.7％(65/102),고우단독경전신성창적성공솔[37.3％(38/102)],차이유통계학의의(x2=14.3,P＜0.01).비두위태인단독경후신성창획득로뇌정중시상절면적성공솔위88.8％(87/98),여단독경전신성창적성공솔[82.7％(81/98)]차이무통계학의의(x2=1.5,P＞0.05).두위태인경전후신성창개획득로뇌정중시상절면적성공솔위9.8％(10/102),저우비두위태인[71.4％(70/98)],차이유통계학의의(x2=79.1,P＜0.01). 결론 후신성창획득태인로뇌정중시상절면적성공솔고우전신,연합채용전、후신성창가이제고획득해절면적성공솔.
Objective To explore the feasibility of combining anterior and posterior fontanelle acoustic windows for fetal median sagittal plane cranial scanning in prenatal ultrasound.Methods From July 5 to August 25 in 2012,200 pregnant women in Huai'an First Hospital at 22 to 24 gestational weeks accepted transabdominal uhrasonography,with anterior fontanelle,longitudinal suture and posterior fontanelle as acoustic windows to obtain the median sagittal plane.In the mean time,ten aborted or induced fetuses (with malformations or maternal complications) underwent cranial ultrasound with the same acoustic windows.The successful rates of obtaining median sagittal plane were calculated.Data were analyzed by Chi-square test.Results (1) Among the ten aborted or induced fetuses,all median sagittal planes were successfully obtained through anterior,posterior fontanelle,or longitudinal suture alone.(2) Among the 200 cases of prenatal uhrasonography,the successful rate of obtaining median sagittal plane through posterior fontanelle alone was 76.0％(152/200),which was higher than that through anterior fontanelle alone [59.5％ (119/200),x2=12.5,P＜0.01].The successful rate was 95.5％ (191/200) when combining the anterior and posterior fontanelle,which was higher than that through anterior fontanelle or posterior fontanelle alone (x2 =74.3 and 31.1,both P＜0.01).The successful rate of obtaining median sagittal plane through posterior fontanelle was 67.3％ (65/102) in cephalic presentation,which was also higher than that through anterior fontanelle [37.3％ (38/102),x2 =14.3,P＜0.01].The successful rate was 88.8％ (87/98) through posterior fontanelle in non-cephalic presentation,which was similar to that through anterior fontanelle [82.7％(81/98),x2 =1.5,P＞0.05].When both anterior and posterior fontanelle applied,the successful rate in cephalic presentation was 9.8％ (10/102),lower than that in non-cephalic presentation fetuses [71.4％ (70/98),x2 =79.1,P＜0.01].Conclusions The successful rate in obtaining median sagittal plane through posterior fontanelle is higher than that through anterior fontanelle,and might be increased when both anterior and posterior fontanelle were used.