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目的探讨引产后骨骼发育异常胎儿进行骨骼X线检查分析对终止妊娠后的骨骼发育异常胎儿的诊断价值。方法选取2014年2月-2016年8月来医院就诊实施引产胎儿52例,按照引产胎儿骨骼是否异常发育分为两组对照观察。其中骨骼异常组15例,孕周16~37周;正常参考组37例,孕周13~34周;均采取骨骼X线检测,探讨骨骼异常胎儿的发育特点与X线特征。结果胎儿发育至13孕周后,机体全身大骨骼均已完成骨化,正常胎儿在胫骨径、腹径、肱骨径、股骨径、髂骨径、髂骨高/髂骨宽均、股骨长径/股骨横径等指标均与胎儿发育妊娠周期有明显相关性;当妊娠周期延长其骨骼发育径距也将增加,胸径/腹径对照比率也将因妊娠周期的延长而缩小。15例胎儿骨骼异常发育X线诊断中,软骨异常发育3例,成骨不全3例,弯腿性发育不良1例,脊椎干髓端发育不良1例,短肋多指综合征1例,软骨成长不全Ⅰ型1例,骨硬化症1例,局灶性股骨发育不良1例,致死性异常Ⅰ型发育2例,窒息性胸廓发育不良1例。结论采取X线技术进行骨骼检出,并依据骨骼发育特异性征象进行骨骼异常发育引产胎儿的诊断分型,重点观察胎儿骨骼发育形态,测量骨骼发育长度,增强胎儿骨骼异常诊断准确性。
Objective To investigate the diagnostic value of skeletal X-ray examination of fetus with skeletal development abnormalities induced by abortion after abortion. Methods From February 2014 to August 2016, 52 cases of induced fetus were admitted to the hospital for treatment and were divided into two groups according to the abnormal development of fetus fetus. There were 15 cases of abnormal skeletal group and 16-37 weeks of gestational age, 37 cases of normal reference group and 13-34 weeks of gestation week. The skeletal X-ray examination was used to explore the developmental features and X-ray features of skeletal abnormal fetus. Results Fetal development to 13 weeks after the gestation, the body has completed the ossification of the big bones, the normal fetus in the tibia diameter, diameter, humeral diameter, femoral diameter, iliac diameter, ilium height / width of the iliac, femur length / Femoral diameter and other indicators were significantly associated with the development of the fetus during pregnancy; as the gestation period to extend its skeletal development will also increase the distance between the diameter of the control / diameter ratio will also be reduced due to the extension of pregnancy. Among the 15 cases with abnormal fetal bone development, there were 3 cases of abnormal cartilage development, 3 cases of osteogenesis imperfecta, 1 case of dysplasia of leg bend, 1 case of dysplasia of spinal cord medulla, 1 case of short ribbed multiple finger syndrome, 1 case of incomplete growth type Ⅰ, 1 case of osteosclerosis, 1 case of focal femoral dysplasia, 2 cases of fatal abnormal type Ⅰ development and 1 case of asphyxiated thoracic dysplasia. Conclusion The X-ray technique is used to detect the bone, and the diagnosis of fetus with abnormal development of skeletal structure is diagnosed according to the specific signs of skeletal development. The fetal skeletal development morphology is mainly observed, the skeletal development length is measured, and the diagnostic accuracy of fetal skeletal abnormalities is enhanced.