CAJ | 학술논문

目的：探讨妊娠早期超声筛查不同绒毛膜性双胎妊娠的价值。方法随机选取于2012年1月～2014年6月到我院进行产前常规超声筛查病例500例，筛选出不同绒毛膜性的双胎胎儿，将其临床最后诊断情况与超声诊断情况进行比较，分析妊娠早期超声筛查双胎的绒毛膜性及在检查胎儿异常中的价值。结果进行产前超声筛查的病例中，双胎妊娠占7.60%，为38例，其中双绒毛膜囊双胎妊娠占81.57%，为31例，单绒毛膜囊双胎妊娠占18.42%，为7例，超声对妊娠早期38例双胎胎儿进行绒毛膜性分类的诊断结果与实际情况完全相符，正确率达89.47%，两组比较无显著统计学差异（P＞0.05），单绒毛膜囊双胎胎儿结构异常情况与超声诊断情况完全相同，正确率达75%，两组比较无显著统计学差异（P＞0.05），双绒毛膜囊双胎胎儿结构异常情况与超声诊断情况仅相差1例，正确率达83.87%，两组比较无显著统计学差异（P＞0.05），单绒毛膜性双胎胎儿孕妇的妊娠期高血压发生率为14.28%，妊娠期糖尿病发生率为14.28%，胎膜早破发生率为28.56%，羊水过多发生率为14.28%，与双绒毛膜性双胎胎儿孕妇的并发症发生情况差异不大，两组比较无显著统计学差异（P＞0.05）。结论妊娠早期超声筛查对于诊断双胎妊娠的绒毛膜性以及胎儿结构异常具有较高的准确性，可有助于准确的判断胎儿畸形，对于孕期处理有着极高的指导意义，值得在临床产前检查中广泛推广。
목적：탐토임신조기초성사사불동융모막성쌍태임신적개치。방법수궤선취우2012년1월～2014년6월도아원진행산전상규초성사사병례500례，사선출불동융모막성적쌍태태인，장기림상최후진단정황여초성진단정황진행비교，분석임신조기초성사사쌍태적융모막성급재검사태인이상중적개치。결과진행산전초성사사적병례중，쌍태임신점7.60%，위38례，기중쌍융모막낭쌍태임신점81.57%，위31례，단융모막낭쌍태임신점18.42%，위7례，초성대임신조기38례쌍태태인진행융모막성분류적진단결과여실제정황완전상부，정학솔체89.47%，량조비교무현저통계학차이（P＞0.05），단융모막낭쌍태태인결구이상정황여초성진단정황완전상동，정학솔체75%，량조비교무현저통계학차이（P＞0.05），쌍융모막낭쌍태태인결구이상정황여초성진단정황부상차1례，정학솔체83.87%，량조비교무현저통계학차이（P＞0.05），단융모막성쌍태태인잉부적임신기고혈압발생솔위14.28%，임신기당뇨병발생솔위14.28%，태막조파발생솔위28.56%，양수과다발생솔위14.28%，여쌍융모막성쌍태태인잉부적병발증발생정황차이불대，량조비교무현저통계학차이（P＞0.05）。결론임신조기초성사사대우진단쌍태임신적융모막성이급태인결구이상구유교고적준학성，가유조우준학적판단태인기형，대우잉기처리유착겁고적지도의의，치득재림상산전검사중엄범추엄。
ObjectiveTo explore the value of ultrasound in screening of different choriocarcinoma gemellary pregnancy at first trimester of pregnancy.Methods500 patients who did antenatal conventional ultrasound screening in our hospital from January 2012 to June 2014 were screened twins fetuses of different choriocarcinoma. The last clinical diagnosis and ultrasonic diagnosis were compared to analyze the value of ultrasound in screening of twins fetuses’ choriocarcinoma and check fetuses’ abnormalities at first trimester of pregnancy.Results 38 patients with gemellary pregnancy accounted for 7.60% in patients who received obstetric ultrasound examination, among which 31 patients with double chorionic sac gemellary pregnancy accounted for 81.75%, and 7 patients with single chorionic sac gemellary pregnancy accounted for 18.42%. The diagnosis results of ultrasound in screening of different choriocarcinoma gemellary pregnancy were completely conformed to the truth, and the accuracy reached to 89.47%. The difference was not statistically significant (P>0.05). The single chorionic sac twins fetuses' structure defect was completely conformed to ultrasound diagnosis, and the accuracy reached to 75%. The difference was not statistically significant (P>0.05). The difference between the double chorionic sac twins fetuses' structure defect and ultrasound diagnosis was only 1 case, and the accuracy reached to 83.87%. The difference was not statistically significant (P>0.05). The occurrence rate of pregnancy-induced hypertension of pregnant woman with single chorionic sac twins fetuses was 14.28%, and the occurrence rate of gestational diabetes mellitus was 14.28%. The occurrence rate of premature rupture of fetal membranes was 28.56%, and the occurrence rate of polyhydramnios was 14.28%. The difference of complications between pregnant women with single and double chorionic sac twins fetuses was small, and the difference was not statistically significant (P>0.05).Conclusion Ultrasound in screening of choriocarcinoma gemellary pregnancy and fetal structural abnormalities has high accuracy, which can help diagnose fetal malformation accurately. It has great guiding significance in treatment during pregnancy, which is worthy of widely application in clinical antenatal examination.