超声检测股骨远端次级骨化中心确定胎龄的临床价值(1)
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【摘要】目的：探讨利用超声检测股骨远端次级骨化中心(SOC)确定胎龄的临床应用价值。方法：对2010年1月-2011年1月在门诊常规产检孕妇700例，选择月经周期不规则或末次月经不详的孕妇350例作为研究组，随机选取月经周期规则的孕妇350例作为对照组，利用超声检测股骨远端SOC的出现时间及最大径线，并分析其与胎龄的关系。结果：孕33周后SOC检出率为95.86%，孕35周检出率100%，大小随胎龄增加而增大。当SOC≥0.6 cm时,94.6%的胎儿≥37周。结论：超声检测股骨远端SOC可以方便快捷地确定胎龄，检出SOC在孕33周左右，≥0.6 cm时可作为胎龄37周及胎儿成熟的标准。
【关键词】超声；次级骨化中心；胎龄
The Clinical Significance of Distal Femoral Epiphyseal Secondary Ossification Center in Estimating Gestational Age/LI Hong-xia,WEI De-zhan,DENG Xiu-zhen,et al.//Meterial Innovation of China，2012，9(10)：080-082
【Abstract】Objective：To investigate the clinical significance of distal femoral epiphyseal secondary ossification center(SOC) in estimating gestational age.Methods：A total of 700 cases for prenatal examination were enrolled into this study from January 2010 to January 2011.350 cases with irregular menstruation or unclear last menstrual period were in study group.The other 350 cases with regular menstruation were randomly chosen as control group.The appearance and maximum diameter of distal femoral epiphyseal SOC were identified and measured by ultrasound to analyse gestational age.Results：The appearance of the SOC was associated with a gestational age of greater than 33 weeks in 95.86% of fetuses,whereas a gestational age of greater than 35 weeks in 100% of fetuses.Measurements of the SOC show that its size increases linearly：when the SOC measures greater than or equal to 0.6 cm,the gestational age is greater than or equal to 37 weeks in 94.6% of fetuses.Conclusion：The sonographic evaluation of distal femoral epiphysis SOC can be used as independent marker for estimation of gestational age during the third trimester.
【Key words】Ultrasound;Secondary ossification center;Gestational age
First-author’s address：Material and Child hospital of Foshan，Foshan 528000,China
doi：10.3969/j.issn.1674-4985.2012.10.049
由于月经不调或末次月经不详，往往难以正确判断胎儿孕龄及其成熟度，目前确定胎龄的方法颇多，但利用超声检测胎儿股骨远端次级骨化中心(Secondary ossification center，SOC)确定胎龄的报道较少。本研究总结了350例月经周期不规则、末次月经不详的孕妇在孕期28~42周个时期的胎儿股骨远端SOC的出现时间及大小，追踪出生后新生儿体重及成熟情况，并与同期350例月经周期正常、规则的孕妇各时期进行对比，总结分析如下。
1资料与方法
1.1一般资料选取2010年1月-2011年1月笔者所在医院常规产前检查，月经周期不规则或末次月经不详的孕妇350例作为研究组 ......
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