胎儿脑发育异常34例临床研究分析.docVIP

胎儿脑发育异常34例临床研究分析 　　【摘要】 目的 研究分析胎儿脑发育异常因素及结局， 早发现早干预， 减少出生缺陷， 提高出生人口素质。方法 从本院围产保健门诊孕妇中筛选出符合条件者， 于妊娠16周、24周、32周进行超声和核磁共振（MRI）检查观察胎儿脑发育情况， 异常者进行干预， 出生后的婴儿进行发育随访。并对年龄、学历、职业等方面进行统计学分析。结果 从1118例符合条件的观察对象中共检出胎儿脑发育异常者34例， 其中典型脑发育畸形23例， 11例轻度异常者经干预后， 出生胎儿7例发育正常， 另4例中1例智力+运动发育稍落后， 3例运动落后， 经康复治疗达正常水平。34例胎儿脑发育异常的孕妇年龄和文化程度经统计学处理， 组间差异有统计学意义（P0.005）。 结论 ①早期发现胎儿脑发育异常是必要的；②彩超检查是最方便、适时、快捷、廉价、准确、无创的首选方法；③MRI是进一步明确诊断的无创检查， 可以协助超声诊断。④仅有轻度脑积水不合并脑发育畸形者可以在严密观察中继续妊娠；⑤≥35岁高龄孕妇或≤20岁低龄孕妇胎儿脑发育畸形的几率明显升高， 最佳生育年龄在25～30岁之间；⑥高中以下文化程度的孕妇胎儿脑发育畸形的比例升高。 　　【关键词】 胎儿；脑发育；畸形；早发现；早干预 　　【Abstract】 Objective To analyze pathogenesis and consequences of fetal encephalodysplasia. The reduction of birth defect rate and the improvement of the quality of the newborn population could be addressed by early diagnosis and intervention of fetal encephalodysplasia. Methods Among the 2368 gravidas with the perinatal health care from Oct. 2011 to Dec. 2012， 1118 cases were sampled. Ultrasonic and MRI examinations were conducted to observe the fetal brain development， on gravidas with 16 week， 24 week and 32 week pregnancy. Detailed documentations including age， education background， and occupation of the sample gravidas were statistically analyzed. Follow-up visits of sample infants were conducted. Results Among the 1118 sampled cases， 34 cases of encephalodysplasia were observed. Twenty-three cases of typical encephalodysplasia were detected via ultrasonic examinations， 11 mild abnormal cases changed life style and were monitored； after birth ， 7 infants grew healthily and 4 infants were later cured through rehabilitation from growth retardations （1 mental and motor retardation cases and 3 motor retardation cases）. The age and education background of those 34 gravidas with intrauterine fetal encephalodysplasia were analyzed and the Result demonstrated a statistical significance （P 　　【Key words】 Fetus； Brain development； Malformation； Early diagnosis； Early intervention 　　随着人口和疾病模式的转变以及出生死亡率的下降， 出生缺陷已成为目前我国婴儿死亡、儿童