摘要
目的探讨超声心动图在胎儿单纯性室间隔缺损(isolated ventricular septal defect,i-VSD)产前诊断、临床分型及出生后随访中的应用价值。方法 6 885例孕妇均于孕18~38周行超声心动图检查,记录胎儿i-VSD检出率、缺损口直径及i-VSD临床分型,比较不同年龄组孕妇i-VSD检出率;筛查出i-VSD且选择继续妊娠者,于新生儿出生后1周行超声心动图检查,并随访1a观察自然愈合情况。结果超声心动图检出i-VSD 105例,彩色多普勒显示心室水平双向分流;临床分型中膜周型67例(63.8%),肌型35例(33.3%),干下型2例(1.9%),多发型1例(1.0%);除干下型2例和多发型1例,余102例缺损口直径0.8~13.8(3.4±2.4)mm;年龄<22岁、22~28岁、>28~35岁、>35岁组i-VSD检出率(1.3%、1.6%、1.5%、1.5%)比较差异均无统计学意义(P>0.05);超声心动图对膜周型缺损口直径<2 mm、2~3mm、>3mm者的显示率(44.4%、91.4%、95.7%)均高于肌型(30.0%、39.1%、50.0%)(P<0.05);105例中17例引产,88例继续妊娠者新生儿出生后1周超声心动图检查结果与孕期检查结果一致62例,随访1a自然愈合24例。结论i-VSD以膜周型和肌型常见,部分可自然愈合,超声心动图在i-VSD产前诊断及出生后随访中具有重要临床价值。
Objective To investigate the clinical value of echocardiography to the prenatal diagnosis and clinical classification of isolated ventricular septal defect （i-VSD） as well as the follow-up survey after birth. Methods Totally 6 885 fetuses in 18 to 38 weeks of gestation underwent echocardiography to record the detection rate, diameter and clinical types of i-VSD, and to calculate the detection rate of i VAD among the pregnant women in different ages. The fetuses with i-VSD received echocardiography one week after birth, and the natural healing rate was observed in one-year follow-up survey. Results In 6 885 fetuses, 105 were found i-VSD on echocardiography, showing ventricular bi-directional shunt on color Doppler flow image, and included perimembranous type in 67 cases （63.8%）, muscular type in 35 （33.3%）, subarterial type in 2 （1.9%）, and multiple type in 1 （1.0%）. The diameter of the defect was 0.8 to 13.8 （3.4±2.4） mm in 102 cases except 2 cases of subarterial type and 1 case of multiple type. The detection rates of i-VSD showed no significant differences among the pregnant women aged %22 years old, 22 to 28 years old, 〉28 to 35 years old and 〉35 years old （1.30%, 1.56%, 1.52%, l. 49%） （P〉0.05）. Echocardiography showed the detection rates of VSD 〈2 mm, 2 to 3 ram and %3 mm in diameter were significantly higher in perimembranous type （44. 4%, 91.4%, 95.7%） than those in muscular type （30.0%, 39. 1%, 50.0%） （P〈0.05）. In 105 fetuses, 17 were induced labor, and 88 continued pregnancy. The neonates received echocardiography one week after birth, which was consistent with the results of prenatal examination in 62 cases. One-year follow up survey showed natural healing in 24 cases. Conclusion The perimembranous and muscular types are the most common types of i-VSD, part of which can be naturally closed after birth. Echocardiography plays an important role in the prenatal diagnosis and follow-up survey after birth.
作者
王沛
冯爱粉
刘莉
WANG Pei , FENG Ai fen, LIU Li(Department of Ultrasound, Heze Hospital, Heze 274000, Chin)
出处
《中华实用诊断与治疗杂志》
2018年第3期284-286,共3页
Journal of Chinese Practical Diagnosis and Therapy
基金
国家自然科学基金(81170321)
关键词
单纯性室间隔缺损
超声心动图
产前诊断
临床分型
Isolated ventricular septal defeet
echocardiography
prenatal diagnosis
clinical type
