胎儿腹腔大血管异常与内脏异位畸形的关系研究  

Study on relation between the fetal abdominal great vessels anormalities and heterotaxy

作　　者：叶风[1] 黄品同[4] 陈蓓蕾[1] 陈利民[1] 陈蓉蓉[1] 马思思[1] 王凯华[2] 叶琼[3] 

机构地区：[1]温州医学院定理临床学院温州市第二人民医院超声科,325000 [2]温州医学院定理临床学院温州市第二人民医院心血管科,325000 [3]温州医学院定理临床学院温州市第二人民医院病理科,325000 [4]浙江大学医学院附属第二医院超声诊断科

出　　处：《中华超声影像学杂志》2011年第2期148-151,共4页Chinese Journal of Ultrasonography

基　　金：温州市科技局项目（Y20090321）

摘　　要：目的 探讨胎儿腹腔大血管异常与胎儿内脏异位的关系及以腹腔大血管异常作为产前超声标志筛查胎儿内脏异位畸形的价值.方法 在我院行产前系统超声检查的6532例孕妇,超声检查胎儿生长径线、腹腔大血管和脏器结构.以腹腔大血管异常的胎儿为研究对象.结果 产前超声共发现胎儿腹腔大血管异常45例,占0.7%.产后证实内脏异位综合征35例,完全性内脏反位7例,3例失访.腹腔大血管异常胎儿畸形总发生率、内脏异位综合征发生率、完全性内脏反位发生率高于腹腔大血管正常胎儿,差异有统计学意义（P＜0.001）.Ⅰ型和Ⅱ型异常内脏异位综合征发生率高于Ⅲ型,差异有统计学意义（P＜0.001）;Ⅰ型左侧异构发生率高,Ⅱ型右侧异构发生率高,差异有统计学意义（P＜0.001）.结论 腹腔大血管异常胎儿均存在脏器的异位或反位;腹腔大血管观察方法 简单,可以作为产前筛查内脏异位畸形的有效超声标志.Objective To investigate the relation between anormalities of fetal abdominal great vessels and heterotaxy, the clinical significance of screening fetal heterotaxy by the abnormalities of fetal abdominal great vessels. Methods 6532 fetuses from our hospital were scanned and the fetuses with abdominal great vessels abnormalities were included. Parameters of fetal growth, abdominal great vessels and anatomical survey were detected. Results Forty-five cases （0.7%） of fetal abdominal great vessels abnormalities were detected prenatally. Forty-two cases were confirmed postnatally, including 35 cases of heterotaxy syndrome and 7 cases of situs inversus totalis and 3 cases missed. The incidences of the abnormal fetus,heterotaxy syndrome and situs inversus totalis of the fetuses with abnormal abdominal great vessels were higher than that of the fetuses with normal abdominal great vessels, the differences were statistically significant（ P〈 0.001）. The incidence of both type Ⅰ and type Ⅱ of the heterotaxy syndrome were significantly higher than that of type Ⅳ （P〈0.001）. There was a high incidence of left isomerism in abnormal type Ⅰ and of right isomerism in abnormal type Ⅱ , the differences were statistically significant （P〈 0.001）. Conclusions Abnormal great vessels abnormalities have strong relations to heterotaxy and situs inversus which can be used as effective and simple indicator in screening heterotaxy syndrome.

关 键 词：超声检查 产前 心血管畸形 左右转位 

分 类 号：R445.1[医药卫生—影像医学与核医学]