产前超声对胎儿早期心脏畸形筛查的价值.pdfVIP

10 • 论 著 • October 2014, Vol.12, No.29 Guide of China Medicine 产前超声对胎儿早期心脏畸形筛查的价值 韩 华 李建玲 常凤玲 杨丹丹 (河南省新乡市中心医院超声影像科，河南新乡453000) 摘要 目的 方法 【 】 探讨胎儿颈项透明层 （NT ）、三尖瓣频谱和心尖四腔观 （FCV ）三者联合应用在胎儿早期心脏畸形筛查中的临床意义。 选取725 例先天性心脏病高危孕妇，所有胎儿孕11~ 14 周检测NT、FCV ；应用脉冲多普勒超声获取三尖瓣血流频谱，进行相应的血流频 谱分析，同时对NT 增厚、三尖瓣反流及四腔心异常的胎儿行超声心动图检查，对可疑CHD 的胎儿于孕18~20 周再次行超声心动图检查 以确诊或除外CHD；其余胎儿于孕20~24 周行胎儿超声心动图检查。所有活产儿于生后 1 周内行超声心动图检查，引产的胎儿争取尸解。 所得结果进行对比分析。结果 NT、三尖瓣频谱、FCV 单独及NT+ 三尖瓣频谱+FCV 联合筛选胎儿心脏病的敏感性分别为53%、47%、 49%、93% 。NT+ 三尖瓣频谱+FCV 的敏感性明显高于其他方法 （P ＜0.05）。结论 NT+ 三尖瓣频谱+FCV 联合应用检测技术简单、易于 普及推广，可明显提高筛选胎儿早期心脏畸形的敏感性。 关键词 【 】心脏缺损；先天性；超声检查；产前 中图分类号：R445.1；R715 文献标识码：B 文章编号：1671-8194（2014）29-0010-02 HAN Hua, LI Jian-ling, CHANG Feng-Ling, YANG Dan-dan (Department of Ultrasound Radiology, Xinxiang Central Hospital, Xinxiang 453000, China) [Abstract]Objective To investigate the clinical significance of nuchal translucency(NT), the tricuspid waveform and the four–chamber view of heart(FCV)as well as combing the three methods to screen for fetal congenital heart disease in the first-trimester pregnancy. Methods NT, FCV and the tricuspid waveform of 725 consecutive fetuses were conducted to high risk pregnancy within 11-14 gestational weeks. Fetuses with increased NT, tricuspid regurgitation and abnormal FCV were followed up with echocardiography. Those fetuses suspected with CHD were re-examined with echocardiography during 18-20 gestational weeks to obviate congenital heart disease. For the rest of study group, echocardiography detections were conducted during 20-24 weeks of gestation. All fetuses were followed up wit