复杂性先天性心脏病在非活产缺陷儿中的发生状况  

Epidemiology of Complex Congenital Heart Disease in Defective Stillbirth Fetus

作　　者：欧艳秋[1,2] 刘小清[1,2] 麦劲壮[1,2] 韩凤珍[1,3] 陈寄梅 潘微[1,5] 庄建 

机构地区：[1]广东省心血管病研究所 [2]广东省人民医院(广东省医学科学院)流行病学研究室,广州市510100 [3]广东省人民医院(广东省医学科学院)妇产科,广州市510100 [4]广东省人民医院(广东省医学科学院)心脏外科,广州市510100 [5]广东省人民医院(广东省医学科学院)心脏儿科,广州市510100

出　　处：《中国循环杂志》2012年第4期302-304,共3页Chinese Circulation Journal

基　　金：广东省科技计划项目(2003C34213);国家重点基础研究发展计划(973计划,2010CB529500);广东省科技计划项目特定任务(2008658-1)

摘　　要：目的:了解复杂性先天性心脏病(CCHD)在非活产缺陷儿中的检出和诊断情况。方法:通过病历回顾的方法选取我院2005-01-01至2010-12-31胎儿及新生儿14 342例,非活产缺陷儿249例。主要诊断手段为胎儿超声心动图。分析CCHD在非活产缺陷儿中的检出率及构成比例。结果:14 342例胎儿及新生儿的先天性心脏病总检出率为10.95‰(157例),非活产缺陷儿的249例(1.74%),CCHD 43例占非活产缺陷儿的17.27%。43例中CCHD的亚型比例分布依次是完全性房室间隔缺损52‰(13例);右心室双出口36‰(9例)、单心室32‰(8例)、大动脉转位24‰(6例)、左心室发育不良综合征等16‰(12例)。95.35%(41/43)的CCHD胎儿孕母选择性终止妊娠。249例非活产缺陷儿中CCHD的检出率女性高于男性(30.38%vs14.55%),差异有统计学意义(P=0.0086),胎儿CCHD平均诊断孕周为(26.9±4.9)周,20～30周诊断病例占67.44%。结论:非活产缺陷儿的CCHD检出率高。胎儿超声心动图技术的提高有助于胎儿时期检测出CCHD。Objective：To investigate the prevalence and diagnosis of complex congenital heart disease（ CCHD）in defective stillbirth fetus. Methods ：We retrospectively studied 14342 fetuses and new born babies in our hospital from 2005 to 2010 ,that including 249 cases of defective stillbirth. All diagnosis was confirmed by fetal echocardiography. The defective rate and the component ratio of CCHD in stillbirth fetuses were analyzed. Results ：The total detective rate of CHD in all birth was 10. 95‰（157/14342） ,the detective rate in defective stillbirth was 1.74% （249/14342）and CCHD in defective stillbirth was 17.27% （43/249）. The CCHD occurrence as complete atrioventricular septal defect in 52‰（ 13/249 ） cases, double outlet of right ventricle in 36‰ cases （9/249）, single ventricle in 32‰ cases （ 8/ 249 ） and great artery conversion in 24%0 cases （6/249）. 95.35% parents of CCHD fetuses chose to terminate the pregnancy. The detective rate for CCHD was higher in female fetuses than that in male （30. 38% vs. 14. 55% ,P = 0. 0086）. The average diagnosis time for CCHD fetuses was （26. 9＋4. 9）weeks of gestation, and 67.44% of diagnosis was made between 20 - 30 weeks of gesta- tion. Conclusion：There was a high detective rate for CCHD in defective stillbirth. Fetal echocardiography was an effective and helpful method for CCHD diagnosis in fetuses.

关 键 词：先天性心脏病 死胎死产 胎儿超声心动图 先天性缺陷 

分 类 号：R541[医药卫生—心血管疾病]