摘要
目的探究产前超声诊断对先天性心脏病的诊断价值和漏诊和误诊的原因。方法选取空军军医大学第一附属医院收治的150例进行产前胎儿心脏超声检查的孕妇为研究对象,选取的时间范围为2016年2月到2018年9月,在胎儿出生前后的超声心动图进行对比,观察产前超声检查漏诊和误诊的情况,采用单因素χ2检验和多因素Logistic回归分析研究造成产前先天性心脏病超声诊断漏诊和误诊的原因,并评价产前超声检查的诊断价值。结果在150例受检产妇当中,发现产前超声诊断漏诊8例,误诊7例,诊断准确率为90%。孕妇年龄>35岁、孕妇增重过多、羊水不足、腹壁瘢痕等是导致产前先天性心脏病超声诊断漏诊和误诊的主要原因(危险影响因素,P<0.05,OR>1);超声诊断的敏感度为0.636,特异度为0.945。结论产前超声诊断对先天性心脏病的诊断准确率高,具有安全、操作简便和无创等特点,有一定的诊断价值。其中注意并尽量避免孕妇年龄过高、增重过多、腹壁瘢痕等主观因素,对羊水进行监测,均可以帮助降低产前先天性心脏病超声诊断的漏诊和误诊。
Objective To explore the diagnostic value of prenatal ultrasound in congenital heart disease and the causes of missed diagnosis and misdiagnosis. Methods 150 pregnant women undergoing prenatal fetal echocardiography in Xi’an Xijing Hospital were selected as the research objects. The time range of the selection was from February 2016 to September 2018. The echocardiograms before and after the birth were compared. The situation of missed and misdiagnosed prenatal echocardiography was observed. Single factor χ2 test and multi-factor Logistic test were used. Regression analysis was used to analyze the causes of misdiagnosis and missed diagnosis of prenatal congenital heart disease. Results The results showed that among 150 cases of pregnant women, 8 cases were missed and 7 cases were misdiagnosed by prenatal ultrasound. The diagnostic accuracy was 90%. Age > 35 years old, excessive weight gain, insufficient amniotic fluid and abdominal scar were the main causes of m isdiagnosis and missed diagnosis of prenatal congenital heart disease by ultrasound(risk factors, P < 0.05, OR > 1);the sensitivity and specificity of ultrasound diagnosis were 0.636 and0.945. Conclusion Prenatal ultrasound diagnosis of congenital heart disease has high diagnostic accuracy,safety, simple operation and non-invasive characteristics, and has a certain diagnostic value. The monitoring of amniotic fluid can help to reduce the missed diagnosis and misdiagnosis of prenatal congenital heart disease by ultrasound.
作者
李春妮
王峥
LI Chun-ni;WANG Zheng(Xijing Hospital,The 1st Affiliated Hospital of Air force Military Medical University,Xi’an Shanxi 710032,China)
出处
《昆明医科大学学报》
CAS
2020年第10期138-143,共6页
Journal of Kunming Medical University
基金
陕西省重点研发计划项目(2017SF-159)。
关键词
产前超声诊断
先天性心脏病
诊断价值
漏诊
误诊
Prenatal ultrasound diagnosis
Congenital heart disease
Diagnostic value
Missed diagnosis
Misdiagnosis
