超声心动图诊断胎儿单纯性室间隔缺损及出生后自然愈合随访  

Echocardiography Diagnosis of Fetal Simple Ventricular Septal Defect and Natural Closure Follow-up After Birth

作　　者：卢芙蓉[1] 常凤铃 李岩[1] 冯俊[1] 

机构地区：[1]河南省新乡市中心医院超声科,河南新乡453000

出　　处：《中国医学影像学杂志》2016年第2期141-143,147,共4页Chinese Journal of Medical Imaging

摘　　要：目的单纯性室间隔缺损(VSD)是最常见的先天性心脏病之一,具有自然闭合性,本研究旨在探讨超声心动图在胎儿VSD的产前诊断及出生后随访其自然闭合中的价值。资料与方法纳入产前超声心动图诊断为单纯性VSD的85例胎儿,分析其超声特征,分析胎儿VSD情况及出生后1年VSD自然闭合的随访结果。结果85例胎儿中,膜周部缺损55例(64.7%),肌部缺损26例(30.6%),漏斗部缺损2例(2.3%),膜周部及肌部同时缺损2例(2.3%)。膜周部、肌部出生前自然闭合分别有2例(3.6%)、4例(15.3%),出生后1年自然闭合分别有13例(23.6%)、14例(53.8%)。漏斗部、膜周部及肌部同时缺损出生后1年均为闭合。膜周部缺损与肌部缺损的内径大小与愈合情况比较,差异均无统计学意义(P>0.05)。胎儿出生后1年随访,肌部缺损自然闭合率明显高于膜周部缺损,差异有统计学意义(P<0.05)。结论胎儿VSD在出生前后均可能自然闭合,与VSD位置及大小有关,单纯肌部VSD较容易闭合。超声心动图是诊断VSD可靠、安全、无创的检查方法。Purpose Simple ventricular septal defect（VSD） is one of the most common congenital heart diseases that can naturally close. The purpose of this study Is to explore echocardiography in prenatal diagnosis and follow-up after the birth for natural closure. Materials and Methods Eighty-five cases of simple VSD fetus were selected for prenatal echocardiographic diagnosis to analyze the imaging characteristics and VSD status. Follow-up imaging was performed 1 year after birth to evaluate VSD natural closure. Results For 85 cases of simple VSD, membranous defect was found in 55 cases（64.7%）, muscular defect in 26 cases（30.6%）, infundibula defect in 2 cases（2.3%）, and defect involving both membranous and muscular portions in 2 cases（2.3%）. Natural closure before birth was noticed in 2 cases（3.6%） of membranous defects and 4 cases of muscular defects（15.3%）. Natural closure 1 year after birth was found in 13 cases（23.6%） of membranous defects and 14 cases（53.8%） of muscular defects. Complex defects involving more than 1 portion of the septum were not closed at 1 year after birth. There were no significance differences between membranous and muscular defects when comparing VSD diameter and closure status（P〉0.05）. At 1 year follow up, the rate of natural closed of muscle defect was higher than that of membranous septal defect（P〈0.05）. Conclusion Fetal simple VSD can close naturally before and after birth, which is associated with the VSD location and size. Pure muscular VSD is easier to close. Echocardiography is a reliable, safe and noninvasive method to diagnose VSD.

关 键 词：室间隔缺损 超声心动描记术 多普勒 彩色 超声检查 产前 自然愈合 胎儿 

分 类 号：R445.1[医药卫生—影像医学与核医学] R71[医药卫生—诊断学]