摘要
目的:探讨各种胎儿先天性心脏病(简称先心病)的围生儿结局和预后,为产前咨询、产后处理提供证据。方法:回顾性分析2005年1月至2009年12月在广东省人民医院产前和(或)产后经彩色超声心动图检查诊断为胎儿先心病151例的临床资料,并分析随访至出生后1～5年的情况。结果:我院的胎儿先心病的发生率为1.25%(151/12056),其中活产104例,引产45例(包括死胎引产1例),死产2例;存活95例,死亡9例(自然死亡6例,心脏矫形术后死亡3例)。简单型先心病占41.06%(62/151),其中61.29%(38/62)是产后诊断,存活率91.94%(57/62)。复杂型先心病占58.94%(89/151),<28孕周诊断者占42.70%(38/89),复杂型先心病的引产率46.07%(41/89),存活率42.70%(38/89)。产前诊断的98例胎儿先心病仅有67例产前行胎儿染色体核型分析,染色体异常发生率为16.42%(11/67)。151例胎儿先心病共有25例患儿行心脏矫形手术治疗,其中简单型先心病8例(术后均存活),复杂型先心病17例(术后死亡3例)。结论:简单型先心病可出生后观察、随访,预后好;近一半复杂型先心病可以在28周内明确诊断,某些复杂畸形可以经医患双方充分沟通后,决定是否引产或出生后限期手术;应重视对胎儿先心病的染色体异常进行产前诊断。
Objective： To investigate the perinatal outcome and prognosis of various fetal congenital heart disease（CHD） to provide evidence for prenatal consultation and postnatal treatment. Methods：A retrospec- tive analysis Of 151 cases of CHD diagnosed by fetal echocardiography prenatal or/and postnatal was done in Guangdong general hospital from Jan. 2005 to Dec. 2009,these fetus were followed up for 1 to 5 years af- ter birth. Results： Incidence of CHD was 1.25% （ 151/12056）, 104 were live birth,45 cases were abortion （including a dead fetus）,2 were stillbirth;95 CHD neonates survived ,9 babies were dead（6 were natural death and 3 death happened after operation）. Simple CHD accounted for 41.06% （62/151） and had a high survival rate （91.94% ,57/62）, among which 61.29% （38/62） were diagnosed after delivery. Complex CHD accounted for 58.94%, of which 42.70% （38/89） were diagnosed before 28 weeks. The induced abortion rate was 46.07% （41/89） ,the survival rate was 42.70% （38/89）. In the prenatal diagnosed group,67 fetus had karyotype analysis, of which 11 cases （16.42%） were chromosomal abnormality. 25 of 151 cases were treated by surgery ,among which 8 were simple CHD （all survived）and 17 were complex type （ 3 were dead after operation）. Conclusions：Simple deformity can be followed up after delivery, the prognosis is good. Al- most half complex CHD can be diagnosed before 28 weeks, some complex type can be corrected after deliv- erv. Attention should be oaid to prenatal screen of abnormal chromosome.
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2012年第9期760-764,共5页
Journal of Practical Obstetrics and Gynecology
基金
广东省科技计划资助项目(编号:2010B060900059)
关键词
先天性心脏病
咨询
随访
处理
Congenital heart disease
Counselling
Follow-up
Management
