胎儿超声心动图在肺静脉畸形引流诊断及预后评估中的应用价值  

Application value of fetal echocardiography in diagnosis and prognosis assessment of anomalous pulmonary venous connection （APVC）

作　　者：徐鹏[1] 李军[1] 王峥[1] 王音[1] 杨文娟[1] 朱霆[1] 庞坤[1] 

机构地区：[1]第四军医大学西京医院超声医学科陕西省胎儿先天性心脏病超声诊断中心,西安710032

出　　处：《中华超声影像学杂志》2017年第5期403-409,共7页Chinese Journal of Ultrasonography

基　　金：陕西省出生缺陷防治科研课题（sxwsjswzfcght2016-012）;陕西省社会发展科技攻关项目（2016SF-098）

摘　　要：目的对比分析超声对肺静脉畸形引流（APVC）的产前诊断及随访结果，探讨胎儿超声心动图对APVC诊断的方法学及预后评估的应用价值。方法对81例经超声心动图检查诊断为APVC的胎儿进行随访，并与产后超声、手术矫治及病理解剖结果进行对比，总结方法学及鉴别诊断要点。结果81例APVC中完全型68例（心上型31例，心内型15例，心下型22例）；部分型13例（心上型2例，心内型10例，心下型1例）；梗阻型（垂直静脉狭窄）10例（均为完全型APVC，心上型4例，心下型6例）；单纯性APVC12例，复合性（合并其他心血管畸形）69例；出生6例（4例单纯APVC行手术矫治且存活，2例复合畸形夭折），待出生2例，终止妊娠71例（病理解剖30例），失访2例。结论胎儿超声心动图对APVC及合并畸形的诊断、分型及预后评估有重要的应用价值。Objective To explore the application value of fetal echocardiography for the diagnosis and prognosis assessment of anomalous pulmonary venous connection （APVC）, by comparing the results of prenatal diagnosis of APVC by ultrasound and follow-up. Methods Eighty-one APVC fetuses diagnosed by fetal echocardiography were followed up regularly. These results were compared with postnatal ultrasound diagnosis, operation and anatomy. The main points of methodology and differential diagnosis were summarized. Results Eighty-one APVC fetuses included 68 cases of total APVC（31 cases of supracardiac type, 15 cases of intracardiac type, 22 cases of infracardiac type）, 13 cases of Partial APVC（2 cases of supracardiac type, 10 cases of intracardiac type, 1 case of infracardiac type） ; 12 cases of isolated APVC, 69 cases of complex APVC（combined with other cardiovascular abnormalities） ;6 cases were born（4 infants of isolated APVC survived after operation, 2 infants of complex APVC died ）, 2 cases were ongoing pregnancy, 71 cases were aborted（30 cases were dissected）, 2 cases were lost to follow-up. Conclusions Fetal echocardiography has important application value in diagnosis and prognosis assessment of APVC and the ones with other cardiovascular abnormalities.

关 键 词：超声心动描记术 胎儿 肺静脉畸形引流 预后评估 

分 类 号：R540.45[医药卫生—心血管疾病]