超声引导下的羊膜腔穿刺术和脐静脉穿刺术在产前诊断中的应用

目的 探讨介入超声技术在产前诊断中的应用效果。方法 对北京妇产医院2004年1月-2005年12月超声引导下的羊膜腔穿刺术和脐静脉穿刺术进行总结。结果 羊膜腔穿刺术一次穿刺成功率100％；脐静脉穿刺术：18^＋1-20w手术时间平均为8．1min，穿刺次数2．2，穿刺成功率89．3％；20^＋1-24w手术时间平均为2min，穿刺次数1．3，穿刺成功率97％；24^＋1-28w手术时间平均为1．3min，穿刺次数1．1，穿刺成功率100％；28^＋1-32w手术时间平均为1．6min，穿刺次数1．4，穿刺成功率98％；32^＋1-38w手术时间平均为5．7min，穿刺次数2．0，穿刺成功率90．3％。手术并发症：胎盘或脐带出血，羊膜腔穿刺术的发生率为1．7％，脐静脉穿刺术为12．2％；心动过缓的发生率，脐静脉穿刺术为6％，羊膜腔穿刺术为0；羊膜腔穿刺术仅1例孕妇发生流产，胎儿丢失率为0．11％，脐静脉穿刺术尚未发生胎儿丢失的病例。结论 高分辨实时超声技术使得羊膜腔穿刺术和脐静脉穿刺术变得更加安全，操作更加简单。

Application of ultrasound-guided amniocentesis and cordocentesis for prenatal diagnosis

Objective:To investigate the role of interventional ultrasound technique for prenatal diagnosis.Methods:Sum-up the procedures of ultrasound-guided amniocentesis and cordocentesis in Beijing Obstetrics and Gynecology Hospital during January 2004 to December 2005.Results:Success rate of first attempt amniocentesis was 100%;Cordocentesis performed between 18 and 20 weeks gestation,the average puncture time was 8.1 min,puncture times was 2.2,the success rate was 89.3%;Cordocentesis performed between 20 and 24 weeks gestation,the average puncture time was 2 min,puncture times was 1.3,the success rate was 97%;Cordocentesis performed between 24 and 28 weeks gestation,the average puncture time was 1.3 min,puncture times was 1.1,the success rate was 100%;Cordocentesis performed between 28 and 32 weeks gestation,the average puncture time was 1.6 min,puncturetimes was 1.4,the success rate was 98%;Cordocentesis performed between 32 and 38 weeks gestation,the average puncture time was 5.7 min,puncture times was 2,the success rate was 90.3%.Complication:The rate of the bleeding from placentas and umbilical cords was 1.7% in amniocentesis,12.2% in cordocentesis;Approximately 6% were complicated by transient bradycardia during cordocentesis,no transient bradycardia case was found in amniocentesis.Only one case had suffered abortion following amniocentesis,the fetal loss rate was 0.11%,no fetal loss case was found in cordocentesis.Conclusion:The high graphics,real-time ultrasonography has made amniocentesis and cordocentesis become more safe and reliable.