目的 研究并探讨产前优生筛查对出生缺陷的干预作用。方法 于2013年1月—2015年12月,选取69 183例孕产妇的临床资料进行回顾性研究,胎儿总数为69 262例,所有孕产妇在妊娠期均进行产前优生筛查,对产前筛查结果进行分析,统计胎儿异常例数,采取相应的产前干预措施,并对未检出胎儿异常的孕产妇进行跟踪随访,观察其妊娠结局,统计出生缺陷儿娩出例数及产前筛查漏检率。结果 69 262例胎儿中,共有7 470例胎儿检出异常,其胎儿异常率为10.79%,其中2013年检出1 910例,2014年检出2 569例,2015年检出2 991例,其检出率分别为9.15%、10.70%、12.17%,最终经产前诊断检查确定为出生缺陷的胎儿共98例,均采用引产术以终止妊娠。对未检出异常的61 792例胎儿进行跟踪随访后发现,其中17例胎儿在孕期流产,有9例出生缺陷儿娩出,其出生缺陷发生率为0.1 457‰,其产前筛查漏检率为0.1 456‰。结论 在产前对孕产妇进行产前优生筛查,并根据产前筛查结果进行相应的干预,可有效检出异常胎儿,及时终止异常妊娠,有利于减少缺陷儿的出生,促进优生优育。

Objective To study and discuss intervention effects of prenatal eugenic screening in birth defects. Methods From January 2013 to December 2015, we did retrospective study on the clinical data of 69 183 cases of pregnant in which there were 69 262 fetal cases, made prenatal eugenic screening for all pregnant women. Prenatal screening results were analyzed, fetal abnormal cases were calculated. We took appropriate prenatal intervention measures, and followed up pregnant women who had no detection of fetal abnormal. We observed the pregnancy outcome, and calculated the defected childbirth cases and prenatal screening miss rates. Results 69 262 cases of fetus, a total of 7 470 cases of fetal abnormalities were detected. The fetal abnormality rate was 10.79%, of which 1 910 cases were in 2013, 2 569 cases in 2014, 2 991 cases in 2015. The detection rates respectively were 9.15%, 10.70%, 12.17%. 98 cases were determined as fetal birth defects by the final prenatal diagnosis examination, in which all adopted induction of labor to terminate pregnancy. 61 792 cases who were not detected anomalies were followed up in which 17 cases of fetus were found and had abortion during pregnancy, and 9 cases of fetal birth defects were delivered . The incidence of birth defects was 0.1 457 ‰, the prenatal screening miss rate was 0.1 456 ‰. Conclusion Pregnant women were made prenatal eugenic screening and according to the result of prenatal screening we took corresponding intervention, which is effective detect abnormal fetus. We may have timely termination of abnormal pregnancy,and reduce birth defects. It may promote human eugenics.

目的 探讨针灸治疗在体外受精—胚胎移植技术的临床效果。方法 以2013年8月—2015年8月在顺德妇幼保健院生殖科,因不孕进入IVF/ICSI周期的108例患者为研究对象,按照随机自愿原则将其分为三组,针刺组、安慰针刺组、对照组各36例,针刺组:在移植前24小时、移植后30分钟进行相关的针刺治疗,安慰针刺组:针刺穴位与妊娠无关,对照组:不使用针刺疗法,比较三组临床效果。结果 治疗后针刺组Ⅰ型内膜血流类型及PI、RI、S/D低于治疗前,Ⅱ+Ⅲ型内膜下血流类型高于治疗前,差异有统计学意义(P＜0.05)。针刺组总有效率高于安慰针刺组、对照组,三组差异有统计学意义(P＜0.05)。针刺组种植成功率、妊娠成功率及活产率均高于安慰针刺组、对照组,三组差异有统计学意义(P＜0.05)。结论 在体外受精—胚胎移植技术中为患者实施针灸治疗可改善子宫内膜下血流情况,提高临床疗效、改善妊娠结局。

Objective To investigate clinical results of acupuncture treatment in vitro fertilization-embryo transfer technology. Methods August 2013-August 2015 reproductive and child health hospital in Shunde branch,due to infertility entering IVF/ICSI cycles of 108 patients for the study,in accordance with the principle of voluntary they were randomly divided into three groups,the acupuncture group,placebo group and control group 36 cases,respectively.Acupuncture group:24 hours before transplantation,30 minutes post-transplant treatment of infertility acupuncture.Placebo group:acupuncture and were unrelated to infertility.The control group:acupuncture was not used.We compared three groups of clinical effect. Results In the treatment of type Ⅰ endometrial blood flow in the acupuncture group type and PI,RI,S/D were significantly lower than before treatment,Ⅱ+Ⅲ,endometrial blood type under were significantly higher than before treatment.the difference was significance(P<0.05). The acupuncture group was more efficient than placebo group and the control group,the three groups was significant(P<0.05). The success rate of acupuncture group planting,the success rate of pregnancy and live birth rates were higher than placebo group and the control group,the three groups was significant differences(P<0.05). Conclusion In vitro fertilization-embryo transfer technology into the implementation of acupuncture treatment for patients can improve blood flow under the endometrium,improve clinical outcomes and improve pregnancy outcomes.