超声心动图诊断胎儿动脉导管提前收缩及其临床意义  

Clinical significance of constriction of the fetal ductus arteriosus diagnosed by echocardiography

作　　者：张云姣[1] 赵博文[2] 刘志聪[1] 蔡洁[1] 范霜月 

机构地区：[1]浙江省金华市人民医院超声科,321000 [2]浙江大学医学院附属邵逸夫医院超声科

出　　处：《中华超声影像学杂志》2013年第4期305-307,共3页Chinese Journal of Ultrasonography

基　　金：浙江省科技厅公益性技术应用研究计划项目（2012C33123）

摘　　要：目的探讨彩色多普勒超声心动图对胎儿动脉导管提前收缩的诊断价值及其临床意义。方法应用彩色多普勒超声心动图对2380例胎儿的动脉导管进行观察，对存在动脉导管提前收缩的胎儿超声心动图表现及相关临床结果进行分析。结果2380例中共检出胎儿动脉导管提前收缩71例（2．98％），其中右心增大58例，合并三尖瓣反流12例，合并心律失常8例，合并心包积液1例。超声均表现为动脉导管内径变窄，肺动脉及邻近的降主动脉扩张，动脉导管弓走形迂曲呈“砂漏”样改变；彩色多普勒及频谱多普勒表现为收缩期及舒张期高速湍流，其收缩峰值流速≥180cm／s，舒张期峰值流速≥35cm／s。结论胎儿超声心动图在胎儿动脉导管提前收缩的诊断中具有重要意义，早期诊断及密切随访可以为临床提供重要的诊断信息，有助于此类胎儿的合理咨询及处理。Objective To explore clinical significance of constriction of fetal ductus arteriosus diagnosed by echocardiography. Methods Seventy-one cases with constriction of fetal ductus arteriosus （DA） and one fetus with premature closure of DA were detected by fetal echocardiography among 2380 singleton fetuses. The echocardiographic characteristics and clinical outcomes were reviewed and analyzed. Results Of 71 cases with constriction of fetal DA, 58 cases were found with right heart enlargement, 12 cases with tricuspid regurgitation, 8 cases with arrhythmia and 1 case with pericardial effusion. The echocardiographic characteristics showed narrowed diameter of DA, dilatation of pulmonary artery and descending aorta was also noted, DA was markedly curved. The peak systolic velocity（PSV） and end- diastolic velocity（EDV） in the ductus arteriosus measured by pulsed Doppler echocardiography increased （PSV≥ 180 cm/s, EDV≥35 cm/s）. All cases were confirmed normal by neonate echocardiography. Conclusions Prenatal echocardiography plays important role in diagnosis of constriction of fetal DA. Early diagnosis and intimate follow-up can direct clinician to offer suitable consultation for parents and management for fetuses.

关 键 词：超声心动描记术 胎儿 动脉导管 

分 类 号：R54[医药卫生—心血管疾病] R714[医药卫生—内科学]