超声测量不同孕周胎儿肝脏的长度及其临床意义

目的　建立不同孕周正常胎儿肝脏长度指标,并观察胎儿宫内生长迟缓(IUGR)、妊娠期糖尿病、母儿血型不合3组异常妊娠妇女治疗前后胎儿肝脏长度的变化。方法　采用超声诊断仪分别测量妊娠18～42周的305例正常胎儿，及24例IUGR、10例妊娠期糖尿病、16例母儿血型不合的妊娠妇女治疗前后胎儿的肝脏长度。结果　（1）正常妊娠胎儿肝脏长度与孕周密切相关，孕28周前胎儿肝脏长度增长速度为每周1.00mm，孕28周后肝脏增长速度为每周1.76mm，两者比较，差异有显著性(P<0.05)。（2）IUGR患者治疗前后胎儿肝脏增长速度分别为每周1.19mm和1.23mm,低于正常胎儿(P<0.05)。（3）妊娠期糖尿病患者治疗前后胎儿肝脏增长速度分别为每周1.63mm和1.63mm，与正常胎儿比较，差异无显著性(P>0.05)。（4）母儿血型不合患者治疗前胎儿肝脏增长速度为每周1.98mm，和正常胎儿比较，差异无显著性(P>0.05)，治疗后胎儿肝脏增长速度为每周1.38mm，明显低于正常胎儿(P<0.05)。结论　胎儿肝脏长度变化可反映胎儿的宫内生长情况，动态测量胎儿肝脏长度可正确评价胎儿宫内生长情况。

Ultrasonic measurement of fetal liver length and its clinical significance

OBJECTIVE: To establish the normal growth velocity of fetal liver length and compare them with those of intrauterine growth retardation, pregnant diabetes and maternal-fetal blood types imcompatible. METHOD: Three hundred and five normal pregnant women and 24, 10, 16 pathological pregnant women of intrauterine growth retardation (IUGR), gestational diabetes and maternal-fetal blood types incompatible respectively had ultrasonographic measurement of fetal liver length at 18 to 42 weeks' gestation. RESULTS: Normal fetal liver length has a linear relation to gestational age, and showed a significantly rapid increase after 28th week with a growth rate of 1.76 mm per week, and 1.00 mm per week before 28th week (P < 0.05). The growth rate of IUGR group before and after therapy were 1.19 mm and 1.23 mm per week, significantly lower than those of normal group (P < 0.05). The growth rate of pregnant diabetes group before and after therapy were 1.63 mm and 1.63 mm per week, no statistical significance with normal group (P > 0.05). The growth rate of maternal-fetal blood types incompatible group before therapy was 1.98 mm, showed no difference with normal group (P > 0.05), but after therapy, the growth rate of fetal liver was 1.38 mm per week, significantly lower than normal group (P < 0.05). CONCLUSION: Dynamic measurement of fetal liver length can help us to understand whether the fetus grow well in uterus and whether the treatments are effective.