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目的探讨B超下经腹脐静脉穿刺术的安全性和临床应用价值。方法回顾性分析2002年1月-2009年12月间在我院进行B超引导下经腹脐静脉穿刺术的969例孕妇,包括穿刺成功率、手术时间及并发症。结果一次穿刺成功率96.8%,二次穿刺成功率99.38%。穿刺时间10m in内934例;10m in~15m in 28例。>30m in 7例,并发症:发生脐带渗血(>15 s)148例,发生率15.27%(148/969);穿刺经胎盘338例,胎盘渗血(>30 s)146例占43.19%(146/338),穿刺术中胎心减慢38例,发生率3.92%(38/969)成功抢救37例,2例胎心减慢胎死宫内,流产2例;早产9例。绒毛羊膜炎1例,胎儿丢失8例,占0.825%。结论经腹脐静脉穿刺是产前诊断安全、简便、可行的方法。熟练掌握穿刺手术技巧,配合默契是手术成功的关键。
Objective To investigate the safety and clinical value of transabdominal umbilical vein puncture with B ultrasound. Methods A retrospective analysis of 969 pregnant women undergoing B-guided transabdominal umbilical venipuncture in our hospital from January 2002 to December 2009 included the successful rate of puncture, operation time and complications. Results The success rate of primary puncture was 96.8% and the success rate of secondary puncture was 99.38%. Puncture time of 1034 in 934 cases; 10m in ~ 15m in 28 cases. 148 cases (148/969) had umbilical cord hemorrhage (> 15 s), and the incidence rate was 15.27% (148/969). There were 146 cases of placenta puncture (> 30 s) (146/338). Fetal heart rate was reduced 38 cases (3.92%, 38/969) in the puncture operation, and 37 cases were successfully rescued. 1 case of chorioamnionitis, 8 cases of fetal loss, accounting for 0.825%. Conclusion Transabdominal umbilical vein puncture is a safe, simple and feasible method for prenatal diagnosis. Proficiency in surgical puncture technique, with the tacit understanding is the key to successful surgery.