49例先天性胎儿心脏疾病的静脉导管血流频谱分析  

To analyse the Ductus venosus Doppler in 49 fetuses with heart disease

作　　者：葛群[1] 伍颖恒 王风蕾 汪雪菁[1] 石彦珍 

机构地区：[1]马鞍山市妇幼保健院超声科,安徽马鞍山243000 [2]广州市妇女儿童医疗中心超声科,广东广州510180

出　　处：《现代生物医学进展》2014年第12期2324-2326,2330,共4页Progress in Modern Biomedicine

基　　金：广州市医药卫生科技项目(2013A011049);马鞍山妇幼保健院院内项目

摘　　要：目的:不同的胎儿先天性心脏疾病通过不同的作用机制影响到胎儿心脏功能,会引起胎儿体内血循环的不同改变。静脉导管是胎儿血循环中重要的组成,也会随之出现相应的频谱改变。通过对49例合并先天性心脏疾病胎儿的静脉导管血流频谱及参数进行分析,研究胎儿不同类型心脏疾病对静脉导管(DV)血流频谱的影响。方法:选取2009年1月至2012年12月间我们在产前超声检查中发现的49例合并先天性心脏疾病的胎儿,分别测量DV血流频谱并进行参数分析,根据DV频谱是否正常分为两组。结果:DV频谱正常组有29例(59.18%),表现为S波、a波的流速和方向正常,PVIV及DVRI指标位于正常范围。DV频谱异常组有20例,表现为S波流速降低、a波缺失或反向,PVIV及DVRI升高。结论:DV血流频谱和参数是评价胎儿心功能的良好指标。不同种类胎儿心脏发育异常对胎儿心功能影响的作用机制不同,其DV频谱也有着不同改变。通过对DV频谱的波形和参数分析,了解胎儿心脏异常的病生理机制,评价其严重程度和预后,这对于指导临床诊疗有着重要意义。Objective：Different congenital fetal heart diseases will affect fetal heart function through different mechanism.This will have different effect on fetal circulation.Ductus venosus（DV） is an important part of fetal circulation.DV Doppler will have different changes accordingly in fetuses with different fetal heart diseases.DV parameters were measured in 49 fetuses,to analyze the changes of DV in fetuses with different heart disease.Methods：49 fetuses with different heart disease were enrolled from January 2009 to December 2012.Fetal ductus venosus（DV） blood flow was measured in every case.All the cases were divided into two groups.Results：29 fetuses in normal group have normal DV（59.18%）.Abormal group have 20 fetuses which have low velocitiy of S wave,high PVIV DVRI and absent or reversed a wave（40.82%）.Conclusion：DV Doppler can effectively evaluate the heart function of fetus.Different fetal heart diseases influence fetal heart function through different pathophysiological mechanism.There will be different changes in the DV Doppler.To analyze the shapes and parameters of DV wave,the pathophysiological mechanism of the heart diseases can be known.Fetuses＇ severity and prognosis can be evaluated.It is important to instruct the clinical diagnosis and treatment.

关 键 词：胎儿 静脉导管 超声多普勒 心脏疾病 

分 类 号：R445.1[医药卫生—影像医学与核医学] R725.4[医药卫生—诊断学]