系统产前超声(Ⅲ级)在中期筛查胎儿先天性心脏疾病的应用价值  

Application value of systemic prenatal ultrasound(Ⅲ level ) in screening of fetal congenital heart diseases in the medium term

作　　者：刘焕玲[1] 董旭东[1] 颜芳[1] 徐红 

机构地区：[1]云南省第一人民医院产科昆明理工大学医学院附属医院,云南昆明650032 [2]昆明市第二人民医妇产科,云南昆明650201

出　　处：《中国妇幼保健》2016年第3期644-646,共3页Maternal and Child Health Care of China

摘　　要：目的探讨系统产前超声(Ⅲ级)在中期筛查胎儿先天性心脏疾病的应用价值。方法选择2 540例接受产前检查的产妇进行超声检查和系统产前超声检查判断先天性心脏疾病,分娩后通过尸检或超声心动图确认先天性心脏疾病。结果经超声心动图或尸检确诊为先天性心脏疾病的患儿83例。系统产前超声检出79例,误诊1例、漏诊3例;常规产前超声检出51例,漏诊12例、误诊20例;常规产前超声灵敏度、特异度、准确度、阳性预测值、阴性预测值分别为61.45%、99.59%、98.35%、83.61%、98.71%,系统产前超声分别为95.18%、99.92%、99.76%、97.53%、99.84%,系统产前超声灵敏度、阳性预测值均明显高于常规产前超声(P<0.05)。系统产前超声对大动脉转位、法洛四联症、主动脉病变、肺动脉瓣病变、室间隔缺损的误诊和漏诊率低于常规产前超声,二尖瓣病变、三尖瓣病变、房间隔缺损的误诊和漏诊率与常规产前超声差异无统计学意义(P>0.05)。结论系统产前超声(Ⅲ级)检查能够更为有效的筛查先天性心脏疾病,尤其对大动脉转位、法洛四联症、主动脉病变、肺动脉瓣病变、室间隔缺损的筛查具有重要价值。Objective To explore the application value of systemic prenatal ultrasound （ Ⅲ level） in screening of fetal congenital heart diseases in the medium term. Methods Ultrasonography and systemic prenatal ultrasonography were conducted among 2 540 pregnant women during prenatal examination, congenital heart diseases were judged according to ultrasonic results; after delivery, congenital heart dis- eases were confirmed by autopsy or echocardiography. Results Eighty-three infants were diagnosed as congenital heart diseases definitely by echocardiography or autopsy, 79 infants were detected by systemic prenatal ultrasonography, one infant was misdiagnosed, three infants were missed diagnosed; 51 infants were detected by conventional prenatal uhrasonography, 12 infants were missed diagnosed, 20 infants were misdiagnosed. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of conventional prenatal ultra- sonography were 61.45%, 99.59% , 98.35% , 83.61%, and 98.71% , respectively; the sensitivity, specificity, accuracy, positive pre- dictive value, and negative predictive value of systemic prenatal uhrasonography were 95. 18%, 99. 92%, 99. 76%, 97.53%, and 99. 84%, respectively. The sensitivity and positive predictive value of systemic prenatal ultrasonography were statistically significantly higher than those of conventional prenatal ultrasonography （ P〈0. 05 ） . The misdiagnostic rate and missed diagnostic rate of systemic prenatal ultra- sonography for transposition of great arteries, tetralogy of Fallot, aortic diseases ,. pulmonary valve diseases, and interventricular septal defect were lower than those of conventional prenatal uhrasonography. There was no statistically significant difference in the misdiagnostic rate and missed diagnostic rate for mitral lesions, tricuspid diseases, and atrial septal defect between systemic prenatal ultrasonography and conven- tional prenatal ultrasonography （P〉0. 05 ） . Conclusion Systemic prenatal ultrasound （ Ⅲ leve

关 键 词：系统产前超声 先天性心脏疾病 中期筛查 超声心动图 

分 类 号：R725.4[医药卫生—儿科]