CAJ | 학술논문

目的：在新疆阿合奇县开展彩超检测胎儿颈项透明层厚度（NT），了解其与胎儿发育异常的相关因素及临床诊断价值，填补阿合奇县产前筛查及产前诊断方面的一项空白。方法：应用PHILIPS iu22彩色多普勒超声诊断仪，对头臀径（CRL）在45-84mm，孕11-13+6周的32例孕妇进行腹部彩超检查，测量胎儿的N T值，并随访至出生后24小时。结果：在32例孕妇中，有3例N T值≥3.0m m。2例N T值≥3.0m m中1例为胎儿脑积水，另1例为胎儿脉络丛囊肿。1例N T值≥3.0m m者，超声随诊至出生后24小时未见明显异常。其余29例孕妇在孕11-13+6周测量NT值均≤3.0mm。但其中有1例超声随诊至出生后24小时证实为先天性足内翻。结论：早期妊娠中，胎儿N T值的异常增厚与胎儿发育异常有着非常密切的关系。孕11-13+6周N T值≥3.0m m作为诊断值，且不受孕妇年龄的影响。本文样本量小，还有待进一步资料积累。新疆阿合奇县地处偏远，条件有限，利用现有资源，对B超医生进行培训，在早孕期开展彩超检测NT厚度，在中孕期开展彩超胎儿畸形筛查，以降低边远地区新生儿缺陷的发生率和死亡率。且无创伤，经济实惠，牧民们容易接受。不久的将来，等实验室条件具备还可以进一步开展唐氏筛查等项目，以逐步提高阿合奇的医疗保健水平，缩短与内地的差距。
목적：재신강아합기현개전채초검측태인경항투명층후도（NT），료해기여태인발육이상적상관인소급림상진단개치，전보아합기현산전사사급산전진단방면적일항공백。방법：응용PHILIPS iu22채색다보륵초성진단의，대두둔경（CRL）재45-84mm，잉11-13+6주적32례잉부진행복부채초검사，측량태인적N T치，병수방지출생후24소시。결과：재32례잉부중，유3례N T치≥3.0m m。2례N T치≥3.0m m중1례위태인뇌적수，령1례위태인맥락총낭종。1례N T치≥3.0m m자，초성수진지출생후24소시미견명현이상。기여29례잉부재잉11-13+6주측량NT치균≤3.0mm。단기중유1례초성수진지출생후24소시증실위선천성족내번。결론：조기임신중，태인N T치적이상증후여태인발육이상유착비상밀절적관계。잉11-13+6주N T치≥3.0m m작위진단치，차불수잉부년령적영향。본문양본량소，환유대진일보자료적루。신강아합기현지처편원，조건유한，이용현유자원，대B초의생진행배훈，재조잉기개전채초검측NT후도，재중잉기개전채초태인기형사사，이강저변원지구신생인결함적발생솔화사망솔。차무창상，경제실혜，목민문용역접수。불구적장래，등실험실조건구비환가이진일보개전당씨사사등항목，이축보제고아합기적의료보건수평，축단여내지적차거。
Objective In Xinjiang Akeqi County, we carry out color Doppler flow imaging diagnosis instrument (CDFI) examinations on fetal nuchal translucency thickness (NT) to find out the related factors and clinical diagnostic values of fetal growth abnormalities so that we can fill in a gap of the prenatal examinations and diagnosis in Akeqi County. Methods:We use Philips iu22 color Doppler flow imaging diagnosis instrument to do abdominal examinations on 32 pregnant women whose babies’ head&hip diameters (CRL) are between 45 mm to 84 mm during their 11–13+6 weeks’ pregnancy in order to measure the fetal NT values followed by extra examinations after birth within 24 hours. Results:In 32 cases of pregnant women, 3 cases of NT values are no less than 3.0 mm. Among these 3 cases, 1 case is fetal hydrocephalus, 1 case is fetal choroid plexus cyst. Another case’s CDFI examinations after birth within 24 hours showed no obvious abnormalities. The NT values of the remaining 29 cases during their 11–13+6 weeks’ pregnancy are all less than 3.0 mm. However, 1 case’s following ultrasound diagnosis after birth within 24 hours is confirmed as congenital strephenopodia. Conclusion:During the early pregnancy, the abnormally higher NT value was closely related to the fetal growth abnormality. As diagnostic values, the NT values during 11–13+6 weeks’ pregnancy which are no less than 3.0 have nothing to do with maternal ages. This paper’s sample size is so small that we needs more date accumulation. As Akeqi County of Xinjiang is in remote area with limited conditions, we need to make good use of all the available resources to train B-type Ultrasonic doctors so that they can carry out CDFI examinations on NT during the early pregnancy and on fetal abnormalities during the middle pregnancy to decrease the rates of infant defect and death in remote areas. This diagnosis is painless and economic and it’s easy for the herdsmen to accept. In the near future, with better laboratory conditions, we can also carry out the examinations on Down’s syndrome to gradually improve the level of medical care in Akeqi, shortening its gap with the mainland.