超声心动图扫查晚孕期胎儿动脉导管瘤的临床意义  

Clinic value of ultrasonogram in exploring fetal ductus arteriosus aneurysm on the third trimester of pregnancy

作　　者：寇红菊[1] 何慧疗[1] 王亮[1] 李秀云[1] 肖莉莉[1] KOU Hong-ju;HE Hui-liao;WANG Liang;LI Xiu-yun;XIALi-li(Department of Utrasonograph-y,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou Zhejiang 325027,China)

机构地区：[1]温州医科大学附属第二医院超声影像科

出　　处：《中国临床医学影像杂志》2019年第11期803-806,共4页Journal of China Clinic Medical Imaging

基　　金：温州市科技计划项目（Y20160481）

摘　　要：目的:探讨超声扫查晚孕期胎儿动脉导管瘤(DAA)的临床意义。方法:选取晚孕期超声诊断为DAA的47例胎儿作为研究对象,另收集晚孕期健康对照组35例。产前测量两组胎儿动脉导管最大内径(DAD)、血流频谱收缩期峰值速度(PSV),并对两组胎儿DAD、PSV、检查孕周、孕妇年龄、出生孕周、出生体质量进行对比分析;产后第3天对两组新生儿行超声心动图检查观察动脉导管情况,对动脉导管异常者持续跟踪随访。结果:两组胎儿出生孕周、出生体质量、孕妇年龄及检查孕周比较,差异无统计学意义(P>0.05);与对照组比较,DAA组DAD、PSV更高,差异均有统计学意义(P<0.05);DAA组产后第3天存在动脉导管异常的比率高于对照组;受试者工作特征(ROC)曲线显示,以产前DAD≥9.15mm作为新生儿动脉导管异常预测的截断值,其敏感度为89.5%,特异度为75.0%;观察3月,除DAA组1例中途失访外,其余新生儿动脉导管异常均完全恢复,无一例与动脉导管相关的并发症。结论:产前利用超声心动图测量晚孕期动脉导管内径,可初步预测产后新生儿动脉导管异常的发生。Objective:To explore the clinic value of ultrasonogram in detecting fetal ductus arteriosus aneurysm(DAA)on the third trimester of pregnancy.Methods:Forty-seven fetal subjects who were diagnosed with DAA were enrolled in this study.Thirty-five fetal subjects with normal ultrasound result were included as control group.Using echocardiography,ductus arteriosus diameter(DAD)and peak-systolic velocity(PSV)of ductus arteriosus in these two groups were obtained.DAD,PSV,checking time,gestational age,birth weight and maternal age were compared between the two groups.All the subjects under-wenta neonatal echocardiogram on the 3 rd days after birth to observe the ductus arteriosus.Neonates with abnormal ductus arteriosus were followed up by echocardiogram.Results:There were no significant differences ingestational age,birth weight,maternal age and checking time between the two groups.DAD and PSV in group DAA were higher than those in control group.DAA group had a high incidence of abnormal ductus arteriosus on the 3 rd days after birth.Receiver operating charac-teristic curve analysis revealed that DAD≥9.15 mm can be a good indicator for the abnormal ductus arteriosus with sensitivity of 89.5% and specificity of 75.0%.During the echocardiographic follow-up,all the abnormal ductus arteriosus recovered with-in 3 months except one case lost.None of the cases had complications related to ductus arteriosus.Conclusion:Echocardiographic parameter obtained from ductus arteriosusprenatally can be a predictor for the occurrence of the abnormal ductus arte-riosus after birth.

关 键 词：胎儿疾病 癌 导管 超声心动描记术 

分 类 号：R714.53[医药卫生—妇产科学]