超声心动图在诊断胎儿心内膜垫缺损临床应用价值.docVIP

超声心动图在诊断胎儿心内膜垫缺损临床应用价值[摘要] 目的 探讨超声心动图产前诊断胎儿心内膜垫缺损的临床应用价值。 方法 回顾性分析产前超声心动图诊断19例胎儿心内膜垫缺损的超声心动图的图像特征，并追踪结果。 结果 16例胎儿心内膜垫缺损的经上级医院超声心动图及尸解或经产后超声心动图证实，3例失访。16例产前超声心动图诊断胎儿心内膜垫缺损中，完全型心内膜垫缺损11例，不完全型心内膜垫缺损4例，1例为大的房间隔缺损。15例胎儿心内膜垫缺损中，7例为单纯的心内膜垫缺损，2例为合并心包积液，3例为合并胸水、腹水，2例为合并大动脉转位，1例为合并肺动脉狭窄。 结论 超声心动图产前诊断胎儿心内膜垫缺损准确率高，具有较好的临床应用价值。 [关键词] 胎儿；心内膜垫缺损；超声心动图；产前诊断 [中图分类号] R445.1 [文献标识码] B [文章编号] 1673-7210（2012）01（c）-0168-02 Diagnostic value of prenatal echocardiography in detecting fetal endocardial cushion defect WANG Shuyun TONG Yajun KANG Honhxia YIN Shuhong LI Juan Department of Ultrasound, Maternity and Child Health Hospital of Daxing Distrit, Beijing 102600, China [Abstract] Objective To explore the clinical diagnostic value of echocardiography in detecting fetal endocardial cushion defect. Methods Sonographs from 19 cases with fetal endocardial cushion defects were recorded during routine fetal echocardiography. Results 16 cases fetal endocardial cushion defect were confirmed including 11 cases complete type and 4 cases incomplete type endocardial cushion defect by postnatal echocardiography or autopsy, 1 case larger atrial septal defect, and 3 cases was lost. In the 15 endocardial cushion defect cases, 7 cases were diagnosed as single endocardial cushion defect, 2 cases were with pericardial effusion, 3 cases were with pleural effusion and ascites, 2 cases with transposition of great arteries and 1case with pulmonary stenosis. Conclusion Fetal echocardiography is the leading diagnostic tool for prenatal evaluation of fetal endocardial cushion defect. [Key words] Fetal; Endocardial cushion defect; Echocardiography; Prenatal diagnosis. 心内膜垫缺损（endocardial cushion defects）是一种心脏间隔缺损，又称房室间隔缺损，范围广，累及房间隔、室间隔及房室瓣膜。其发生率约占先天性心脏畸形的7%，出生婴儿中发生率约1/3 000[1]。心内膜垫缺损的自然病程预后很差，完全型心内膜垫缺损患儿80%在2岁内死亡[2]，该畸形已被中华医学会超声指南列为在孕18~24周中必须明确诊断的胎儿致命性心脏畸形，在超声检查中具有重要意义[3]。本文回顾性总结分析了自2007年以来我院超声心动图诊断的19例胎儿心内膜垫缺损的诊断体会及声像图特征，探讨超声心动图产前诊断胎儿心内膜垫缺损的临床应用价值。 1 资料与方法 1.1 一般资料 选取2007年8月~2011年8