超声对胎儿单纯室间隔缺损在宫内和产后婴儿期闭合情况的研究  

Study on Closure Process and Influential Factors of Isolated Ventricular Septal Defect during Fetal Period and Infancy Using Ultrasound

作　　者：赵庆华[1] 李晓君[1] 辛兆芹[1] 

机构地区：[1]聊城市人民医院超声科,山东聊城252000

出　　处：《中国医疗设备》2010年第12期135-138,共4页China Medical Devices

摘　　要：目的应用超声心动图观察胎儿期及产后婴儿期单纯室间隔缺损（IVSD）自然愈合的情况及影响因素。方法选取61例诊断有胎儿单纯性室缺但不愿终止妊娠的孕妇为研究对象,对胎儿进行二维和彩色多普勒超声心动图检查,记录胎儿室间隔缺损的位置、形态、大小、自然闭合的时间和闭合率,出生后存活的婴儿监测室间隔缺损（VSD）上述指标至1岁,计算宫内及产后1年的闭合率及总的闭合率、不同位置室缺的闭合率,并对不同大小室缺的闭合率进行组间比较。结果在61例中,22例（36.1%）宫内自然闭合,9例（14.8%）在产后1年内闭合,30例（49.2%）仍未闭合。室间隔缺损的大小以及缺损的位置与愈合率有关,室间隔缺小于3.0mm的闭合率明显高于室缺为3.1~5.0mm的闭合率（P=0.005）和5mm以上室缺的闭合率（P=0.002）,但室缺为3.1~5.0mm的闭合率与大于5mm的室缺的闭合率之间无显著性差异（P=0.39）。膜部和肌部缺损的闭合率明显高于干下型室缺的闭合率（P≤0.01）,肌部缺损的闭合率高于膜部缺损的闭合率,但两者之间无统计学差异（P=0.65）。结论单纯室间隔缺损有较高的宫内自然闭合率并且在产后婴儿期仍能自然闭合,这种自然愈合的过程与室间隔缺损的位置和大小显著相关。肌部和膜部缺损最容易愈合,干下型不易闭合;小缺损具较高的闭合率,较大的缺损不易闭合。Objective To evaluate the spontaneous closure process of isolated ventricular septal defect and influential factors during fetal period and infancy using fetal echocardiography.Methods 61 fetuses with isolated ventricular septal defect（IVSD） were included in this study and examined using two-dimensional ultrasound and color Doppler,the location,size,closure time of the ventricular septal defect were recorded,these indexes were also registered during foetal period.The closure rate during uterus and infancy were calculated and the general rate was also calculated,the comparison between groups were performed.Results In all cases,22 fetuses（36.1%） were closed in utero,9 infants（14.8 %） were closed during the first year after birth,and 30（49.2%） remained unclosed.The size and location of the ventricular septal defect were correlated to the closure rate.The closure rate of VSD 3.0mm were significant higher than that of the VSD=3.1-5.0mm（P=0.005） and that of the VSD5mm（P=0.002）,the closure rate of the VSD=3.1-5.0mm were higher than that of the VSD5mm,but there were no significant difference（P=0.39）.The closure rates of muscular and the perimembranous VSD were significant higher than that of the subarterial ventricular septal defect（P≤0.01）.The closure rates of muscular VSD was higher than that of the perimembranous VSD,but there was no significant difference（P=0.65）.Conclusion Isolated ventricular septal defect can close spontaneously during fetal period and infancy and has a high closure rate in utero.The size and location of the ventricular septal defect were correlated to the closure rate.The muscular and perimembranous VSD were easily closed,but the subarterial ventricular septal defect was difficult to close.the small defect was easily closed and the big defect was difficult to close.

关 键 词：超声心动图描记术 单纯性室间隔缺损 自然愈合 胎儿 

分 类 号：R817.8[医药卫生—影像医学与核医学] R734.2[医药卫生—放射医学]