目的 探讨中、晚孕期胎儿左心室评估指标的正常参考值范围.方法 随机选取进行超声检查的正常胎儿168例,应用脉冲多普勒测量中孕期(20～24+6周)、晚孕期(30～34+6周)胎儿左心室等容收缩时间(ICT)、等容舒张时间(IRT)、射血时间(ET),计算心肌做功(Tei)指数,统计分析各参数指标的正常参考值范围.结果 中孕期胎儿左心室ICT平均测定值为(34.28±9.92)ms,高于晚孕期胎儿平均测定值的(31.91±8.93)ms(P＜0.05);中孕期胎儿左心室IRT平均测定值为(40.42±7.43)ms,低于晚孕期胎儿平均测定值的(42.35±7.75)ms(P＜0.05);中孕期胎儿左心室ET平均测定值为(170.21±14.95)ms,与晚孕期胎儿平均测定值(169.66±14.49)ms比较,差异无统计学意义(P＞0.05).中、晚孕期Tei指数均为0.44±0.09.结论 胎儿左心室Tei指数正常参考值范围为0.44±0.09,可为进一步评估异常胎儿心功能提供参考.

孕妇26 岁,孕1 产0 ,外院超声示胎儿左上腹囊实性包块;无特殊病史及家族史.查体及实验室检查均未见明显异常.孕36 周超声:胎儿左上腹近中线处?腹主动脉左前方?左肾与左肾上腺之间3. 6 cm × 2.6 cm 囊实性包块,边界较清,周边见绕行血管(图1A) ;考虑左肾上腺出血.

Cantrell综合征是一种罕见的先天性发育异常,新生儿发病率约为 0.055‰[1].Cantrell 综合征包括体外心、胸骨下部缺损、前膈缺损、心包缺陷、脐上高位的腹壁缺损5类畸形,患儿常合并心内畸形.Cantrell综合征患儿常由于心脏及腹内器官严重异位引发呼吸困难、心力衰竭、感染甚至猝死等,预后较差.产前超声可在孕期发现位于体腔外的心脏而行进一步诊断.既往报道的 Cantrell 综合征的诊断多集中于中孕期或晚孕期,本研究拟分析 Cantrell 综合征的超声特征,为产前超声诊断提供依据.

Objective:To explore the normal reference value range of normal fetal lung volume and lung weight to body weight ratio(FLB) in the second trimester and third trimester,and to evaluate the correlation between fetal lung volumes and gestational age.Methods:198 gestational age 18 ～39 +6weeks fetal left and right lung volumes were measured by three-dimensional ultrasound VOCAL rotation technology.Fetal weight was assessed by two-dimensional ultrasound and Hadlock equation system.FLB were calculated.The normal reference value range of normal fetal lung volume and FLB were calculated.The correlation between fetal lung volumes and gestational age was assessed by Pearson correlation analysis.Results:The volumes of left lung,right lung and total lung increased with the increase of gestational age and body weight.The volumes of left lung,right lung and total lung were highly correlated with gestational age and fetal weight(The left lung volume,r =0.970,P ＜0.001.The right lung volume,r =0.972,P ＜ 0.001.The total lung volume,r =0.970,P ＜ 0.001.),and the correlation coefficient was 0.970,0.972,0.970,0.978,0.984,0.979.The FLB did not change with gestational age,and the normal range was about 0.026-0.032.Conclusions:The fetal lung volumes increase with the increase of gestational age and fetal weight in second trimester and third trimester.The normal reference range of fetal lung volume and FLB can provide important theoretical basis for evaluation of fetal lung development.

目的 探讨二维超声心动图联合时间-空间关联成像(STIC)技术在胎儿心脏筛查中的应用价值.方法 进行二维超声扫查及三维STIC成像,观察两种方法对胎儿心脏结构异常的诊断结果与各切面显示合格率,并记录二维超声及STIC扫描时间.结果 单纯二维超声心动图与二维超声联合STIC技术两种检查方法对92例胎儿心脏结构的显示满意率分别为96.74％与98.91％,差异无统计学意义;二维筛查时间,平均每个胎儿心脏用时(9.70 ±2.15) min,每幅图像所用时间(1.05±0.82)min;STIC技术扫描时间,平均每次STIC扫描用时(7.78±2.44) min,每幅图像所用时间(0.80±0.58) min,把两种方法所得到的每个病例样本和每幅图像的时间进行比较,差异均有统计学意义(P＜0.05).结论 STIC技术较二维超声在胎儿心脏检查中缩短了检查时间,二维超声联合STIC技术在胎儿心脏结构检查中的满意率有所提高.

目的：探讨运用三维超声第三平面观察及测量小脑蚓部；方法：利用三维超声第三切面对379例孕22-35周正常孕妇进行小脑蚓部大小及面积测量；结果：对正常孕妇进行测量的小脑蚓部随着孕周增大，面积也逐渐增大，二者呈正相关。结论：三维超声第三切面进行小脑蚓部测量，方法简单，重复性高，可在小脑蚓部发育畸形方面发挥更大价值。

目的 应用超声筛查软指标异常和血清学筛查两种方法筛查染色体异常,以评估其临床应用的价值.方法 选取定期产检的孕妇3 015例,记录孕妇血清学筛查及孕期超声结果、染色体核型分析结果及新生儿随访情况.结果 3015例接受筛查孕妇中,血清学筛查高风险者171例,孕期B超存在超声软指标者123例,染色体核型分析显示异常21例,发生率为0.69％ (21/3 015);4组筛查方法的正确指数,分别为0.66、0.34、0.14和0.87;染色体数目异常7例(3.76％),染色体结构异常8例(4.30％).结论 将超声软指标阳性及血清学筛查高风险任何一项作为筛查指标进行诊断,可降低染色体异常的漏诊率,两种方法联合,可提高其敏感度.

To determine the normal range of the inner diameters of the anatomical structures in the fetal cardiovascular system during the second trimester in Ningxia and to investigate their variation with gestational age. Routine echocardiography was performed for 1247 normal fetuses during the second trimester (22-28 weeks) to determine the inner diameters of the atrium, ventricle, foramen ovale, aorta, pulmonary artery, left/right pulmonary artery, aortic isthmus, descending aorta, and ductus arteriosus. Measurement data were grouped by gestational age, and the correlation between the measurement data and gestational age was investigated. The inner diameters of the fetal atria, ventricles, and great vessels increased with gestational age and were significantly associated with gestational age (P < 0.05). In Ningxia, determining the normal range of fetal cardiovascular diameters during the second trimester allows the evaluation of fetal cardiovascular system development and provides an important basis for the accurate identification of fetal congenital heart disease.

To determine the normal range of the inner diameters of the anatomical structures in the fetal cardiovascular system during the second trimester in Ningxia and to investigate their variation with gestational age. Routine echocardiography was performed for 1 247 normal fetuses during the second trimester (22~28 weeks) to determine the inner diameters of the atrium, ventricle, foramen ovale, aorta, pulmonary artery, left/right pulmonary artery, aortic isthmus, descending aorta, and ductus arteriosus. Measurement data were grouped by gestational age, and the correlation between the measurement data and gestational age was investigated. The inner diameters of the fetal atria, ventricles, and great vessels increased with gestational age and were significantly associated with gestational age (P < 0.05). In Ningxia, determining the normal range of fetal cardiovascular diameters during the second trimester allows the evaluation of fetal cardiovascular system development and provides an important basis for the accurate identification of fetal congenital heart disease.

中晚孕期胎儿超声心动图检查作为产前超声检查的重要措施已被广泛用于临床,而先天性心脏病的尽早检出有助于及早采取干预措施,具有重要的临床意义.本研究旨在测量并分析妊娠11～13+6周正常胎儿房室瓣、静脉导管的血流频谱参数,建立95％参考值范围,为早孕期筛查胎儿先天性心脏病及相关异常提供一定理的论依据.

目的 探讨孕妇年龄、既往自然流产次数、既往人工流产次数与先兆流产患者保胎治疗结局的关系.方法 选取2012年4月-2012年12月就诊于宁夏医科大学总医院的先兆流产患者136例,对先兆流产患者均给予保胎治疗,随访保胎治疗结局,分析患者年龄、既往自然流产次数、既往人工流产次数与本次保胎治疗结局的关系.结果 136例患者经保胎治疗及随访,妊娠成功者104例,保胎失败者32例.先兆流产患者中,保胎成功者104例,平均年龄(27.89±4.78)岁,保胎失败者32例,平均年龄(29.69±6.03)岁,两组患者年龄差异无统计学意义(t=1.029,P＞0.05).年龄＜35岁的患者保胎治疗成功率显著高于年龄≥35岁的患者(P＜0.05).既往无流产史、流产1次和流产2次以上的3组患者间保胎成功率的差异均无统计学意义(P＞0.05).结论 年龄≥35岁的患者较年龄＜35岁的患者保胎治疗后成功率低,临床保胎治疗需适当考虑年龄因素;既往自然流产和人工流产次数对先兆流产患者保胎结局无明显影响.

目的 探讨产前超声检查胎儿颈部透明层(NT)对胎儿畸形诊断的临床意义.方法 选择孕龄为11～ 14周且胎儿头臀径在45～ 84 mm行产前超声检查单胎妊娠孕妇342例,分析筛查对象中NT异常胎儿的妊娠结局.结果 342例筛查对象中NT正常胎儿329例,NT增厚胎儿13例.随访到257例正常分娩病例,出生后检查异常者9例.NT增厚13例患儿中,1例失访,1例分娩后新生儿正常,其他11例均引产,其中1例21三体,2例胎儿合并先心,8例颈部水囊瘤合并其它畸形.结论 NT增厚与多种胎儿畸形及不良妊娠结局有关,产前超声检查NT无创伤,适用于各年龄阶段孕妇,其可作为早期筛查胎儿畸形的一个重要指标.

目的 分析产前超声检查诊断胎儿单脐动脉结合胎儿染色体核型分析对孕妇进行正确的产前咨询的价值.方法 回顾性分析2011年1-12月在宁夏医科大学总医院行超声检查发现的18例单脐动脉,对其超声特征、胎儿染色体核型、产前咨询建议、妊娠结局进行随访分析.结果 18例胎儿单脐动脉病例中,其中16例单胎妊娠,2例双胎妊娠;9例单纯性单脐动脉,9例单脐动脉合并其他系统胎儿发育异常,其中染色体异常2例.随访结果中9例单纯性单脐动脉孕足月分娩,新生儿正常,8例引产,1例失访.结论 单纯单脐动脉大多预后良好,产前咨询建议继续妊娠、定期随访;单脐动脉合并多发畸形者,若合并染色体异常,建议终止妊娠.临床医师应对胎儿单脐动脉进行正确的产前咨询,做好孕妇的孕期保健工作.

目的探讨产前超声诊断先天性消化道畸形的价值。方法选择进行产前超声检查及住院分娩的18 267例孕妇资料进行回顾性分析,以产后最终诊断及随访情况评估产前超声诊断的价值。结果在18 267例进行产前超声检查的孕妇中,发现并成功随访21例消化道异常的胎儿,其中食道闭锁3例,十二指肠狭窄或闭锁10例,下消化道闭锁2例,肛门闭锁2例,巨结肠1例。另外3例分娩后检查示无消化道狭窄或闭锁。结论产前超声检查可以显示消化道扩张的部位和程度,是诊断先天性消化道梗阻的重要方法。

目的 探讨血清钙及尿酸水平与子痫前期的关系.方法 选取轻度子痫前期孕妇49例,重度子痫前期孕妇62例,正常妊娠者65例,分别测定其血清钙、尿酸水平并作比较.结果 轻度子痫前期组、重度子痫前期组及正常对照组孕妇血清钙水平分别为(2.16±0.11)mmol/L、(2.03±0.14) mmol/L及(2.16±0.11)mmol/L,轻度子痫前期组、重度子痫前期组孕妇血清钙水平均低于正常对照组,差异有统计学意义(P＜0.05),重度子痫组低于轻度子痫组(P＜0.05);轻度子痫前期组、重度子痫前期组及正常对照组孕妇血清尿酸水平分别为(326.36±60.57)mol/L、(381.98±78.21) mol/L及(263.80±63.79)mol/L,轻度子痫前期组及重度子痫前期组孕妇血清尿酸水平均高于正常对照组(P＜0.05),重度子痫前期组孕妇血清尿酸水平高于轻度子痫前期组(P＜0.05).结论 孕妇血清钙、尿酸水平与子痫前期严重程度密切相关,可作为子痫前期诊断及预测指标,对子痫前期的早发现、早治疗具有重要意义.

目的 探求超声联合血清学指标在孕中期筛查胎儿染色体病的临床效果和可靠性. 方法 对自愿接受产前筛查的孕15～20周的孕妇应用血清甲胎蛋白(AFP)、游离人绒毛膜促性腺激素(β-hCG)、雌三醇(μE3)生化指标及超声检查进行孕中期筛查,应用软件计算风险值,以21-三体综合征风险率1/270、18-三体风险率1/350作为风险截断值,对高风险孕妇进行产前诊断；同时进行超声筛查,超声筛查综合评分大于2分者,也行产前诊断. 结果 接受筛查的12,605例孕妇中,血清学指标筛查高风险者824例,确诊为染色体异常39例.超声筛查综合评分大于2分者298例,随访确诊为染色体异常24例.联合筛查阳性232例,确诊为染色体异常43例. 结论 超声检查和血清筛查联合应用,可有效提高胎儿染色体异常的检出率,降低筛查假阳性率,减少染色体病胎儿出生.

Objective To detect and analyze the pathogenic characteristics and clinical features of gestational reproductive tract infections and to provide a reliable basis for clinical therapy.Methods 1492 pregnant woman and 1500 no-pregnant patients were selected,vaginal secretions were examined by routine smear,and the PH of vaginal secretions were measured and the pathogens were tested,the Infection types of the two groups were analyzed.Results In 1492 cases of pregnant patients with lower genital tract infections,bacterial vaginosis(BV) and vulvovaginal candida disease(VVC) mixed infection rate was the highest(55.43%).In the single pathogen infections,BV was the highest(17.56%),and followed was VVC(11.46%).Reproductive tract infections in all age groups during pregnancy showed that 26 to 30-year-old pregnant women were the highest infection rate crowd in all age groups.For 1500 cases of non-pregnancy patients with infection,BV infection rate was highest(29.80%),and followed was VVC(22.27%).There was significant difference between the two groups.BV and VVC mixed infection rate of pregnancy group was higher than that in non-pregnant group,the rest pathogen infections rates of pregnancy group were lower than those in non-pregnant group.Conclusion BV and VVC mixed infection is the most common type of infection in gestational reproductive tract infections.It could provide individualized programs for clinical treatment according to the characteristics of the disease and improve the therapeutic effect.

Objective To estimate the clinical value and reliability of ultrasound screening for fetal chromosomal diseases in the second trimester.Methods The women at about 18-24 weeks gestation who were willing to accept ultrasound screening were detected in the second trimester.Pregnent women who found foetal deformities or two index were abnormal should auept prenatal diagnosis.Results All of 11 065 pregnant women were screened,and 206 of them were abnormalby ultrasound examination,detection rate was 1.86%,187 women accept prenatal diagnosis,16 fetuses' chromosomes were abnormal.One baby was found to be abnormal after birth.So the rate of chromosomal abnormalities was 9.09%.Conclusion Ultrasound screening could increase detection rate of fetal chromosomal abnormality,reduce congenital abnormal babies and avoid excessive invasive examination effectively.