彩色多普勒超声心动图诊断胎儿先天性心脏畸形价值.docVIP

【摘要】 目的 探讨彩色多普勒超声心动图对胎儿先天性心脏畸形诊断的临床价值。方法 对彩色多普勒超声心动图对25例胎儿心脏进行产前、产后检查分析，运用先心病的三节段分析法及胎儿腹部横切面、四腔心切面、左右心室流出道切面、大动脉短轴切面、主动脉弓长轴切面、动脉导管切面和上下腔静脉切面探查胎儿心脏，并对心脏结构及血流分布进行观察。结果 超声心动图对25例胎儿心脏异常孕妇进行检查，产前检出心脏畸形13例,正常12例；产后复查心脏畸形12 例，正常11例，诊断符合率为92%(23/25),漏、误诊2例，漏、误诊率为8%(2/25)。结论 彩色多普勒超声心动图能够在产前对胎儿先天性心脏畸形做出正确诊断。 【关键词】 胎儿心脏；彩色多普勒超声心动图；先天性心脏畸形 　Prenatal Doppler Echocardiography diagnosis of congenital heart malformation LI Jun-ren, QIE Zhan-jun, JIA Mei, et al. 　　(The Affiliated Hospital of Ningxia Medical University, Yinchuan 750004, China) 　　［Abstract］ Objective To discuss the clinical value of the Doppler echocardiography for detecting fetal congenital heart malformation.Methords 25cases of hearts were examined before and after delivery. The 3-step-analysis method was carried out in fetal abdomen transverse section, 4-chamber section, left-right outflow tract, big atrial short-axis section, long axis section of the aortic arch and long axis section of inferior-outferior vena cava to observe the anatomical structures of heart and the characteristics of blood flow.Results 25 fetuses with doubtful heart diseases were examined. 13 cases were diagnosed with heart diseases, 12 ones were diagnosed to be normal before delivery. 12cases had heart diseases and 11ones were normal after delivery. The diagnostic concordant rate was 92% (23/25). 2 cases were misdiagnosed or failed to be diagnosed, the missed rate was 8% (2/25).Conclusion the Doppler echocardiography can make right diagnosis to congenital heart diseases of fetuses. ［Key words］ Fetal heart; Doppler echocardiography; congenital heart malformation 　　先天性心脏病的发病率为活产婴儿的7‰-8‰［1］ ，我国每年约有15万新生儿患各类先天性心脏病,严重影响儿童的生命健康和人口质量。本研究总结了我院自2007-2009年以来经超声心动图诊断的25例胎儿结果现分析如下。 　　1 材料和方法 　　1.1 研究对象：选择2007-2009年对经常规胎儿超声筛查心脏异常的25名孕妇进行胎儿超声心动图检查，孕期27-35周,平均33周。年龄23-38岁，平均28岁。 　　1.2 方法: 采用美国Vivid7彩色多普勒超声诊断仪,探头频率3-5MHz，选用胎儿心脏显像模式。孕妇取平卧位或者侧卧位,首先行常规胎儿超声检查，再对胎儿心脏进行胎儿腹部横切面、四腔心切面、左右心室流出道切面、大动脉短轴切面、主动脉弓长轴切面、动脉导管切面和上下腔静脉切面等多切面检查,对胎儿心脏复杂畸形辅