摘要
目的探讨中孕期产前超声筛查胎儿先天性心脏病(congenital heart disease,CHD)的临床价值。方法对1 198例孕妇于孕中期进行二维超声及超声多普勒检查,观察胎儿左、右室流出道、三血管、主脉弓、肺动脉和动脉导管弓切面等多个切面,进行产前及产后比较,分析产前筛查胎儿CHD的类型及准确率。结果共检出胎儿先天性心脏畸形12例,占1.00%(12/1 198),其中室间隔缺损2例,房间隔缺损3例,可疑室间隔缺损1例,心内膜垫缺损2例,单房、单室并右侧房室瓣骑跨1例,左心发育不良1例,大动脉转位1例,法洛四联症1例。产前筛查发现的12例先天性心脏畸形胎儿中,11例符合中孕期胎儿CHD筛查结果(由出生后超声心动图确诊,其中1例为室间隔缺损,孕晚期超声心动图检查证实),占91.67%(11/12),1例复杂先天性心脏畸形基本符合中孕期胎儿CHD筛查结果(单房、单室并右侧房室瓣骑跨,经引产后胎儿尸检证实),占8.33%(1/12)。漏诊1例室间隔缺损(经产后新生儿超声心动图证实),漏诊率7.70%(1/13)。结论产前超声对中孕期胎儿CHD的诊断准确性较高,检测出的CHD主要为室间隔缺损及房间隔缺损。
Objective To analyze the clinical value of ultrasound technology in screening out the congenital heart disease（CHD）of the fetus for women in the second trimester of pregnancy.Methods 1 198 cases were selected and examined by two-dimensional ultrasound and Doppler ultrasound（in the second trimester of pregnancy）.The data were collected by observing the outflow tracts of the left and right ventricular,three vessels,main aortic arch,pulmonary artery and arterial catheters of the fetus prenatally and postnatally respectively and compared to analyze the types and accuracy of screening out the fetal congenital heart disease prenatally.Results 12 cases with fetal congenital heart malformation were detected in the trimester of pregnancy,and the percentage was only 1.00%.Among the 12 cases,there were 2cases with ventricular septal defect,3cases with atrial septal defect,1cases with suspected ventricular septal defect,2cases with endocardial cushion defect,1case with single atrium,single ventricle and straddling of right atrioventricular valve,1case with hypoplastic left heart,1case with transposition of the great arteries,and 1case with tetralogy of Fallot.The screening results of 11 cases were confirmed to be accurate,that of 1case was almost accurate,and that of 1case with ventricular septal defect turned out to be missed diagnosis.Conclusion Prenatal ultrasonic examination is accurate in screening out CHD in the second trimester of pregnancy,and the types of CHD screened out are mainly ventricular septal defect and atrial septal defect.
作者
张昌余
赵静
邹旷妮
Zhang Changyu Zhao Jing Zou Kuangni.(Department of Ultrasonography, Maternal and Child Health Hospital of Guangyuan , Guangyuan 628017, China)
出处
《成都医学院学报》
CAS
2016年第4期478-480,484,共4页
Journal of Chengdu Medical College
关键词
胎儿
产前筛查
先天性心脏病
超声
Fetus
Prenatal screening
Congenital heart disease
Echocardiography
