超声心动图对孕中晩期胎儿动脉导管早闭及狭窄的诊断价值  

Diagnostic value of Echocardiography in Early Closure and Stenosis of Fetal Ductus Arteriosus in the middle and Late Pregnancy

作　　者：徐光莲 XU Guang-lian(Chongqing Yongchuan District Childrens Hospital, Chongqing 402160)

机构地区：[1]重庆市永川区儿童医院,重庆402160

出　　处：《医学临床研究》2019年第6期1059-1062,共4页Journal of Clinical Research

摘　　要：【目的】探讨超声心动图(ECG)对孕中晚期胎儿动脉导管早闭及狭窄的诊断价值。【方法】回顾性分析本院2017年1月至2019年1月22例孕中晚期经产后确诊为动脉导管早闭及狭窄胎儿的临床及ECG资料。比较患儿产前和产后的ECG影像特征,评估ECG诊断胎儿期动脉导管早闭及狭窄的临床价值。【结果】超声心动图对于胎儿动脉导管早闭及狭窄诊断准确率为90.91 %(20/22),漏诊2例。胎儿期动脉导管早闭及狭窄胎儿超声心动图特点:右心增大(右心房平均直径为14.3 mm、右心室平均直径为14.7 mm),三尖瓣伴有轻中度以上反流,平均反流速度为(163.75± 13.42)cm/s,平均跨瓣压差为(61±11)mmHg;肺动脉瓣轻中度以上反流,平均反流速度为(243.84±19.50)cm/s,平均跨瓣压差为(29±9)mmHg。20例胎儿均出现不同程度肺动脉増宽,肺动脉内径与主动脉内径的比值大于1.2。动脉导管内径变小,平均内径为(2.3±0.7)cm,超声可见湍流血流信号,导管内收缩期血流速度>170.0 cm/s。出生后24 h超声心动图特点:未探及动脉导管及其血流信号,右心房平均直径为(13.7±0.6)cm,右心室平均直径为(11.7±0.5)cm;三尖瓣反流速度较胎儿时期降低,平均血流速度为(246.37±11.08)cm/s,肺动脉增宽有所好转,肺动脉平均内径为(9.0±0.4)mm。出生后3个月超声心动图特点:右心房、右心室的直径、肺动脉压力均恢复正常;16例患儿无三尖瓣反流,6例患儿伴有轻度三尖瓣反流。【结论】超声心动图检查应用产前诊断胎儿动脉导管早闭及狭窄的价值较高,利于临床医师评估病情,为临床分娩时间提供依据。[Objective] To explore the diag nostic value of echocardiography (ECG) in early closure and stenosis of fetal ductus arterio sus in late pregnancy.[ Methods] The clinical and ECG data of 22 fetuses with premature closure and stenosis of ductus arteriosus diagnosed postpartum in our hospital from January 2017 to January 2019 were retrospectively analyzed. The prenatal and postpartum ECG imaging features were compared to evaluate the clinical value of ECG in the diagnosis of premature closure and stenosis of ductus arteriosus in fetus.[Results]The diagnostic accuracy of echocardiography for early closure and stenosis of fetal ductus arteriosus was 90.91 %(20/22), and 2 cases were missed. Fetal echocardiographic features of premature closure and stenosis of ductus arteriosus during fetal period: right heart enlargement (mean diameter of right atrium 14.3 mm, mean diameter of right ventricle 14.7 mm), tricuspid valve with mild to moderate regurg让ation, mean regurgitation velocity (163.75±13.42) cm/s, mean transvalvular pressure difference (61 ± 11) mmHg;pulmonary valve mild to moderate regurgitation, mean regurgitation velocity (243.84 ± 19.50) cm/s, the average transvalvular pressure difference was (29±9) mmHg. Pulmonary artery widening was observed in all 20 fetuses. The ratio of pulmonary artery diameter to aortic diameter was greater than 1.2. The mean diameter of the ductus arteriosus was (2.3±0.7) cm. Turbulent flow signals could be seen by ultrasound. The systolic flow velocity in the duct was more than 170.0 cm/s. 24 h postnatal echocardiographic characteristics: without detecting the arterial duct and its blood flow signals, the average diameter of right atrium was (13.7±0.6) cm, and the average diameter of right ventricle was (11.7 ±0.5) cm;the tricuspid regurgitation velocity was lower than that of fetal period, the average blood flow velocity was (246.37±11.08) cm/s, the pulmonary artery widening was improved. and the average diameter of pulmonary artery was (9.0±0.4) mm. Three months after bir

关 键 词：动脉导管/畸形 超声检查 产前 

分 类 号：R714.15[医药卫生—妇产科学]