摘要
目的探讨彩超(CDU)在早孕期经腹穿刺绒毛活检术(CVS)中的作用及术中注意事项。方法运用CDU引导下经腹部对28例确诊的孕妇行CVS。术前运用CDU观察叶状绒毛着床位置并于体表标记穿刺点及穿刺范围,术中实时引导入针并抽吸绒毛,重点对穿刺时机及操作技巧进行探讨。结果运用CDU观察穿刺入路及周围血管情况,避开肠管、大血管及周围重要脏器,尽量选择叶状绒毛分布较宽处为穿刺点。取材时间为孕10～13周,平均11周。28例中,一次取材成功26例,2次成功1例,取材失败1例,总成功率为96.4%。所有病例术后即时超声观察,均可见胎心搏动,胎盘部位无明显较大血肿回声。所有病例术后1周复查,均可见胎心搏动,25例继续妊娠者定期随访无一例流产。结论CDU引导下经腹壁穿刺行CVS,其操作简便、安全、可门诊操作,是早期产前诊断的重要方法。术前掌握好穿刺点的定位、穿刺技巧及穿刺时机是取材成功的关键。
Objective To study the operation of chorionic villus sampling （CVS） guided by color Doppler ultrasound （CDU） via abdomen puncture during early pregnancy and investigate the advertences during the operation. Methods CVS guided by CDU probe via abdomen puncture were operated on 28 pregnant women who had the indications of antenatal diagnosis. CDU was used to observe the im plantation position of the foliaceous villis and help setting mark of the puncture point and puncture range on body surface before operation. The needle was punctured under real-time ultrasound guidance and villis were aspirated during the operation. The choice of the right time of puncture and the operation skills were emphasized in the study. Results The CVS puncture approach should be set through CDU ob servation, which attend to avoid the surrounding blood vessels, intestinal canal and surrounding important organs. The puncture point should be chosen in a point where lobiformed villis distributed wider and with a larger scope. The operations were performed from 10 to13 weeks of pregnancy, with an average of 11 weeks. Among these 28 cases, 26 were successfully drawn materials in one time, 1 in twice and 1 failure, with the total ratio of achievement was 96.4%. For all the cases, fetal heart pulsating could be seen by real-time CDU observation right after the operation, and no larger hematoma echo in the placental site occurred. Ultrasound reexamined one week after the operation, fetal heart pulsation could be found in all cases, and no abortion cases occurred after regular follow-up in 25 continued pregnant patients. Conclusion Abdominal CVS puncture guided by CDU probe is conveniently operated, safe and available in clinic. It is an important method for antenatal diagnosis during early pregnancy. The puncture localization, skills and the time are the key points for the success in obtaining the materials.
出处
《影像诊断与介入放射学》
2008年第5期221-223,共3页
Diagnostic Imaging & Interventional Radiology
关键词
彩超
穿刺
绒毛活检术
活检
Color Doppler ultrasound
Puncture
Chorionic villus sampling
Biopsy
