彩色多普勒超声对诊断儿童先天性心脏病的价值研究  

作　　者：柯斌[1] 潘泽群[1] 亢卫华[1] 黄尧垚[1] 

机构地区：[1]广东汕头市中心医院超声科儿科,515031

出　　处：《中国社区医师（医学专业）》2013年第9期253-254,共2页

摘　　要：目的:探讨彩色多普勒超声(CDU)对儿童先天性心脏病类型诊断,并对其预后进行判断的临床应用价值。方法:回归性分析收治250例儿童先天性心脏病的彩色多普勒超声特点,并随访0.5～2年,以观察其预后情况。结果:左向右分流型180例(72.0%),右向左分流型52例(20.8%),无分流型18例(7.2%),单纯畸形中以室间隔缺损发病率最高发,检测出51例(20.4%)。房、室间隔缺损管径<4mm者,随年龄增长,80.7%可自然闭合;缺损4～6mm者,52.4%可自然关闭;>6mm者,80%需要手术治疗。对于动脉导管未闭患儿,管道直径<2mm者,随访2年,87.5%可关闭;导管未闭2～4mm者,60.0%可愈合;动脉导管>4mm者,100%需要手术治疗。合并其他心血管畸形如肺动脉狭窄或闭锁、大动脉转位、肺静脉异常等的重症先心病患者,其死亡率高达89%。结论:彩色多普勒超声能早期对儿童先天性心脏病做出准确的诊断,并对部分类型先心病预后做出评估和预判,从而为指导临床治疗有比较高的应用价值。Objective ： To explore Color Doppler Ultrasound （ CDU ） in diagnosis of the type of congenital heart disease in chil- dren, and the clinical value in judgement of theirs prognosis. Method：we made a regres- sion analysis of the characteristics of Co!or Doppler ultrasound in 250 cases children with congenital heart disease, and observed theirs prognosis with follow - up of 6 months to 2 years. Result： In all the cases, left to right shunt in 180 cases（72.0% ） ,right -to - left shunt in 52 cases（20.8% ） ,no shunt in 18 cases （ 7.2% ） , the highest incidence of congenital heart disease was Ventricular septal defect, was detected in 51 cases （20. 4% ）. When the diameter less than 4ram in atrial septal defect and ventricular septal defect, 80. 7% of patients could be natural closed, and only 52.4% natural close in the defect diameter between 4ram and 6mm, while the defect diameter more than 6mm,80% require surgery. For the pa- tients of patent duetus arteriosus with the pipeline diameter less than 2mm,87. 5% of the patients could be natural closed, and 60. 0% natural close in the defect diameter between 2mm and 4mm ,while the defect di- ameter more than 4mm, 100% require sur- gery. Severe congenital heart disease pa- tients combined with other cardiovascular malformations such as pulmonary stenosis or atresia, transposition of great arteries, pul- monary vein anomalies, the mortality rate of up to 89%. Conclusion：Color Doppler ultra- sound can early make an accurate diagnosis of children with congenital heart disease, and can make a prognosis assessment for some types of congenital heart disease, and also has a high value to guide clinical treat- ment.

关 键 词：彩色多普勒超声 先天性 心脏病 儿童 

分 类 号：R445.1[医药卫生—影像医学与核医学]