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胎儿颈项透明层增厚及静脉导管多普勒血流频谱异常在先天性心脏病患儿筛查中的效果观察 被引量:13

Effect observation of fetal nuchal translucencythickening and abnormal ductus venous Doppler flow frequency spectrum on screening children with congenital heart diseases
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摘要 目的研究并探讨胎儿颈项透明层(NT)增厚及静脉导管多普勒血流频谱异常在先天性心脏病患儿筛查中的效果。方法选取2014年1月~2016年7月在我院产科门诊进行产前检查的3000例孕妇作为研究对象,于孕11~13+6周对孕妇进行彩色多普勒超声检查,测定胎儿NT厚度和静脉导管血流频谱,根据孕妇超声检查结果,对胎儿NT增厚、静脉导管血流频谱异常的孕妇于18~20周进行超声心动图检查,对胎儿NT厚度、静脉导管血流频谱均正常的孕妇于20~24周复查超声心动图,并于出生后或流产后对胎儿进行超声心动图检查或尸检,分析胎儿NT增厚、静脉导管血流频谱异常对先天性心脏病的筛查结果。结果 3000例孕妇经彩色多普勒超声检查,共有64例孕妇检出胎儿NT增厚、静脉导管血流频谱异常,经尸检证实共有59例孕妇宫内胎儿为胎儿心脏畸形,其余2936例胎儿NT厚度、静脉导管血流频谱均正常的孕妇中,经出生后超声心动图复查证实,共109例为心脏畸形。胎儿NT增厚、静脉导管血流频谱异常对先天性心脏病的筛查灵敏度、特异度、准确性分别为92.19%、94.23%、96.20%。胎儿NT增厚、静脉导管血流频谱异常与先天性心脏畸形的发生密切相关,且成正相关(r=0.697、0.726,P<0.05)。结论胎儿NT、静脉导管血流频谱可作为孕早期胎儿先天性心脏病筛查的重要指标,有利于及时发现先天性心脏畸形,便于及时采取措施。 Objective To study and explore the effects of fetal nuchal translucency(NT) thickening and abnormal ductus venous Doppler flow frequency spectrum on screening children with congenital heart diseases(CHD).Methods From January 2014 to July 2016,3000 pregnant women visited our obstetrical clinic for prenatal examinations were selected as research objects.From 11 to 13+6weeks,color Doppler ultrasonography for these participants was used in order to determine NT thickness and ductus venous flow frequency spectrum.According to ultrasonic results of these pregnant women,echocardiography was performed from 18 to 20 weeks if there were abnormalities in NT thickness and ductus venous flow frequency spectrum.The ultrasonic cardiogram was reexamined for these pregnant women with normal NT thickness and ductus venous flow frequency spectrum from 20 to 24 weeks.The echocardiography or autopsy was performed after birth or abortion in order to analyze the effects of fetal NT thickening and abnormal ductus venous Doppler flow frequency spectrum on screening the CHD.Results Among 3000 pregnant women by color Doppler ultrasonography,64 ones with fetal NT thickening and abnormal ductus venous flow frequency spectrum were detected.By autopsy,59 pregnant women were confirmed with fetal heart malformations.For the rest 2936 pregnant women whose fetal NT thickness and ductus venous flow frequency spectrum were all normal,109 cases were testified heart malformations by echocardiographic examination after birth.Thesensitivity,specificity and accuracy of fetal NT thickening and abnormal ductus venous flow frequency spectrum on screening CHD were 92.19%,94.23% and 96.20%,respectively,they were positively correlated with CHD(r=0.697,0.726,P〈0.05).Conclusion Fetal NT and ductus venous flow frequency spectrum can be considered as vital indexes on screening fetus with CHD at an early stage.It is helpful to detect congenital heart malformation in time and take timely measures.
出处 《中国当代医药》 2017年第26期87-89,共3页 China Modern Medicine
关键词 先天性心脏病 筛查 胎儿颈项透明层厚度 静脉导管血流频谱 Congenital heart disease Screening Fetalnuchal translucencythickness Ductusvenous flow frequency spectrum
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