彩色多普勒超声诊断胎儿脐带绕颈的临床优势

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目的:探究彩色多普勒超声扫描(即彩超,CDFI)在胎儿脐带绕颈中的具体诊断作用。方法:择取2012年3月到2015年3月这三年间本院收治的610例孕妇,首先为其进行二维超声初检,再为其进行彩超扫描检测,观察并统计胎儿发生脐带绕颈的几率以及产妇的产后结果,并进行对照研究。结果:二维超声初检有116例确诊为脐带绕颈,诊出率为19.02%,符合率为66.67%。彩超诊断结果为174例产妇发生胎儿脐带绕颈,产后有171例得到证实,即彩超在胎儿脐带绕颈的诊断中,准确率达到98.28%,诊出率为28.52%。彩超诊断正确率要远远高于二维超声,P<0.05,统计学有差异。彩超频谱显示S/D比值超过3.0且同时胎心率出现明显升高、每分钟在180次以上的患者有4例;同时胎心率出现了明显的降低、每分钟在100次以下的患者有1例。结论:彩超可以较为准确地检测到脐带的血流变化,有效弥补了二维超声诊断中存在的缺陷,有助于产妇在分娩期得到更好的临床处理。到目前为止,彩超是产前检查脐带绕颈方法中诊断准确率最高的方法。 Objective: To explore the specific diagnostic role of color Doppler ultrasound (CDFI) in the fetal umbilical cord around the neck. Methods: From March 2012 to March 2015, 610 pregnant women admitted to our hospital during the three years from March 2012 to March 2015 were enrolled in this study. The first two-dimensional ultrasonography was performed on the pregnant women and the color Doppler ultrasound examination was performed. The umbilical cord around the neck The chance of maternal postpartum and the results of controlled studies. Results: The first two-dimensional sonography 116 cases were diagnosed as umbilical cord around the neck, the diagnosis rate was 19.02%, the coincidence rate was 66.67%. Color Doppler ultrasound diagnosis of 174 cases of maternal fetal umbilical cord around the neck, postpartum 171 cases have been confirmed, that is, ultrasound in the diagnosis of fetal cord around the neck, the accuracy rate of 98.28%, the diagnosis rate was 28.52%. Color Doppler ultrasound diagnostic accuracy is much higher than two-dimensional ultrasound, P <0.05, statistically significant differences. Color ultrasonography showed S / D ratio of more than 3.0 and a significant increase in fetal heart rate at the same time, more than 180 times per minute in patients with 4 cases; at the same time there was a significant decrease in fetal heart rate, less than 100 times per minute in patients with 1 case. Conclusion: Color Doppler ultrasonography can accurately detect the changes of umbilical cord blood flow, and effectively make up for the defects existing in two-dimensional ultrasound diagnosis, and help the maternal to get better clinical treatment during childbirth. So far, color Doppler ultrasound is the method of prenatal examination of the umbilical cord around the neck method of diagnosis of the highest accuracy.
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