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目的:通过收集足月生产、早产及过期产数据,综合分析通过测量股骨远端骨骺中心(FE)+胫骨近端骨骺中心(TE)直径与测量双顶径(BPD)+股骨长度(FL)+胎盘分级的不同两种方法所预测的胎龄及胎儿成熟度,对比两种不同方法的准确度,从而更好地实现对胎儿胎龄及胎儿成熟度的有效监控。方法:选取2012年3月-2013年12月间在怀集县人民医院进行常规产检且月经周期不规则或末次月经不详的中晚期单胎孕妇200例,随机分成观察组和对照组,每组各100例。并采用B超测定这200名不同孕周胎儿股骨远端骨骺中心(FE)及胫骨近端骨骺中心(TE)的最大直径线,通过与BPD+FL的测量数据进行对比,对胎盘进行分级评定,由此来判定胎龄及胎儿成熟度。结果:FE和TE的直径值均随胎龄增加而增大,成线性相关。因而,可以根据FE的直径判断胎儿成熟程度,由临床经验以及概率统计表明,当FE是直径≥6 mm时,94%的胎儿≥37周。结论:利用超声测量FE、TE直径用于判定胎龄及胎儿成熟度的技术经研究证实较目前我市普遍采用的测量BPD+FL+胎盘分级的技术在准确性上具有压倒性优势,同时其方法简便、无痛无创、快速、经济、安全。可以方便快捷地为末次月经不详或者月经周期不规则的孕妇提供胎儿成熟度的客观依据,可以为接诊医师尽早诊断胎儿生长受限(FGR)提供重要参考,确保可及时治疗FGR。
OBJECTIVE: By collecting data of full-term production, premature delivery and overdue production, a comprehensive analysis was conducted by measuring the diameter of the distal femoral epiphyseal center (FE) + proximal tibia epiphyseal center (TE) and the measurement of biparietal diameter (BPD) + femoral length + Placenta grading two different methods of predicting the gestational age and fetal maturity, comparing the accuracy of the two different methods, so as to better realize the fetal gestational age and fetal maturity monitoring effectively. Methods: A total of 200 middle-to-late singleton pregnant women with regular menstruation or irregular menstruation in the Huaiji County People’s Hospital from March 2012 to December 2013 were randomly divided into observation group and control group, and each group 100 cases each. The maximum diameters of distal femoral epiphyseal center (FE) and proximal tibial epiphyseal center (TE) of 200 fetuses of different gestational weeks were measured by B ultrasound. The placenta was graded according to the measurement data of BPD + FL , To determine gestational age and fetal maturity. Results: The diameters of FE and TE increased linearly with the increase of gestational age. Thus, the degree of fetal maturity can be judged by the diameter of the FE, as demonstrated by clinical experience and probability statistics, with 94% of fetuses ≥37 weeks when FE is ≥ 6 mm in diameter. CONCLUSIONS: The technique of measuring the FE and TE diameters by ultrasound for the determination of gestational age and fetal maturity has been proved to be overwhelmingly accurate in accuracy compared with the commonly used techniques for measuring placental grading of BPD + FL in our city at present. Simple, painless non-invasive, fast, economical and safe. It can quickly and objectively provide the objective evidence of fetal maturity for the pregnant women with the last menstruation or irregular menstruation. It can provide an important reference for clinicians to diagnose early fetal growth restriction (FGR) and ensure timely treatment of FGR.