早孕期NT超声检查在胎儿畸形筛查中的临床应用价值探究【摘要】目的：分析早孕期二?S彩超胎儿颈项透明层厚度（nuchaltranslucency，NT）超声对胎儿畸形筛查的诊断效果，为产前胎儿排畸筛查工作提供可靠的理论依据。方法：回顾性选取2015年1月-2016年6月本院接诊的孕11～13+6周的孕妇6691例作为研究对象，其中NT值超过2.5mm的有58例，对全部入选者进行引产或随访至胎儿出生后，探讨孕早期二维NT彩超和孕中期三维超声检查对胎儿排畸筛查的诊断效果和价值分析。结果：孕早期NT诊断发现，胎儿NT值58例异常者中有22例（37.93%）合并胎儿畸形，均选择引产；36例胎儿NT值异常孕妇在16～18周进行羊水穿刺染色体检测，发现染色体异常胎儿12例，均选择引产；对其余24例孕妇在孕中期进行超声检测发现胎儿畸形6例（10.34%），均选择引产。以出生和引产结果为金标准，随访至出生18例孕妇正常分娩出的胎儿在6691例研究对象中，孕早期阳性预测值为100%，阴性预测值为50.00%，敏感性为61.11%，特异性为100%，准确率为99.73%。结论：早孕期NT超声筛查能够及早发现胎儿畸形问题，有助于孕妇做出理性的判断，可降低孕妇身心伤害和经济损失，加强超声诊断水准，有较好的社会价值。【关键词】早孕期；NT超声检查；胎儿畸形筛查ExplorationoftheClinicalApplicationValueofNTUltrasonographyinEarlyPregnancyScreeningforFetalMalformations/YUANXue-ying，CAOYan，LAIYu-mei.//MedicalInnovationofChina，2017，14（12）：134-137【Abstract】Objective：Toanalyzethediagnosticvalueoffetalnuchaltranslucency（NT）ultrasonographyinthescreeningoffetalmalformationsatearlypregnancy，andtoprovideareliabletheoreticalbasisforantenatalscreening.Method：6691pregnantwomenaged11-13+6weeksadmittedtoourhospitalfromJanuary2015toJune2016wereretrospectivelychosen.Amongthem，58fetuseswithNTvalueofmorethan2.5mmwerefollowedupforallthefetuseswhowereenrolledorbornafterbirth.ThediagnosticvalueandvalueoftwodimensionalNTcolorDopplerultrasoundandthreedimensionalultrasoundinthesecondtrimesterofpregnancyinscreeningfetalabnormalities.Result：NTdiagnosisinearlypregnancy，fetalNTvaluein58casesofabnormalin22cases（37.93%）withfetalmalformation，wereselectedinduction，theyallchoseinductionoflabor；36casesofabnormalfetalNTvalueweredetectedbyamniocentesisat16-18weeks，andchromosomeabnormalitywasfoundin12cases，theyallchoseinductionoflabor；theother24pregnantwomenweredetectedbyultrasoundinthesecondtrimesterofpregnancy，andtherewere6cases（10.34%），theyallchoseinductionoflabor.Thegoldstandardofbirthandinducedlabor，basedonthegoldstandardofbirthandinducedlabor，18fetuseswerefolloweduptothenormalbirthofthepregnantwomeninthestudyof6691cases，thepositivepredictivevaluewas100%，thenegativepredictivevaluewas50.00%，thesensitivitywas61.11%，specificitywas100%，andtheaccuracywas99.73%.Conclusion：NTultrasoundscreeninginearlypregnancycanfindouttheproblemoffetalmalformationasearlyaspossible，whichishelpfulforpregnantwomentomakerationaljudgment，andcanreducethephysicalandmentalharmandeconomiclossofpregnantwomen，itisofgreatsocialvaluetostrengthenthelevelofultrasonicdiagnosis.【Keywords】Earlypregnancy；NTultrasound；FetalmalformationsscreeningFirst-author’saddress：MaternalandChildHealthCareofHeyuanCity，Heyuan517000，Chinadoi：10.3969/j.issn.1674-4985.2017.12.038随着伴有先天性缺陷的新生儿在我国逐年增多，早期筛查对于防止新生儿缺陷和改变孕妇妊娠结局均有相当重要的影响。同时，先天性胎儿畸形为造成围产儿死亡的最主要原因之一，因而，如果能及早发现先天畸形胎儿在临床上有重要意义[1-4]。伴随现今超声在临床的应用日益成熟，其分辨率不断提高，早孕期彩超系统性筛查已成为...