不同类型胎儿心律失常的围产期处理及结局  

Perinatal management and outcome of different types of fetal arrhythmia

作　　者：颜璨[1] 余艳红[1] 欧阳淑媛[2] 李胜利[3] 姚远[3] 陈琮瑛[3] 文华轩[3] 肖志莲[3] 廖玉媚[3] 

机构地区：[1]南方医科大学南方医院妇产科,广东广州510515 [2]南方医科大学附属深圳妇幼保健院,中心实验室,广东深圳518028 [3]南方医科大学附属深圳妇幼保健院,超声科,广东深圳518028

出　　处：《南方医科大学学报》2011年第6期987-990,共4页Journal of Southern Medical University

基　　金：国家自然科学基金(60671043);国家“十一五”科技支撑计划(2006BAI05A04)~~

摘　　要：目的探讨不同类型胎儿心律失常的围产期处理及结局。方法回顾性分析2003年10月2010年12月在深圳市妇幼保健院经超声心动图筛查诊断为胎儿心律失常的病例。结果共筛查胎儿心律失常130例,其中期前收缩59例、窦性心动过缓23例、窦性心动过速16例、房室传导阻滞12例、房颤3例、其他心律失常17例。其中12例（9.2%）合并先天性心血管畸形,胎儿心动过缓多见。心律失常不同分类之间的预后有显著性差异（P=0.000）。心律失常分类（P=0.024）、合并先天性心脏病（P=0.000）及胎儿水肿（P=0.008）是胎儿预后不良的危险因素。结论大部分阵发性心律失常胎儿在严密监护保守治疗下,胎儿预后良好,胎儿心动过缓预后较差。胎儿心律失常围生期预后与胎儿心律失常分类、是否伴有心血管或其他畸形。Objective To evaluate the perinatal management and outcome of different types of fetal arrhythmia. Methods A retrospective analysis was conducted among the fetuses with arrhythmia identified by M-mode and pulsed Doppler echocardiography in a？single institution between October 2003 and December 2010. Results A total of 130 fetuses were found to have fetal arrhythmia. The most common arrhythmia？during pregnancy was extrasystole （n=59）, followed by bradycardia （n=23）, tachycardia （n=16）, atrial flutter （AF, n=3）, atrioventricular block （AVB, n=12） and other arrhythmia （n=17）. The overall incidence of cardiac anomalies （commonly fetal bradycardia） was 9.2% in these cases. The prognosis of arrhythmia differed significantly between cases of different classifications. The type of fetal arrhythmia （P=0.024）, presence of congenital heart defect （CHD, P=0.000） and fetal hydrops （P=0.008） were significant risk factors associated with termination of pregnancy. Conclusion Fetal arrhythmias without CHD or hydrops under close monitoring often have good clinical outcome, while fetal bradycardia is associated with a high mortality rate. CHD and the presence of fetal hydrops are significant risk factors for pregnancy termination

关 键 词：胎儿 心律失常 先天性心脏病 

分 类 号：R714.5[医药卫生—妇产科学]