产前超声诊断胎儿完全性肺静脉异位引流的价值  

VALUE OF PRENATAL ULTRASOUND IN THE DIAGNOSIS OF TOTAL ABNORMAL PULMONARY VENOUS DRAINAGE

作　　者：张海燕[1] 张宇 郭全伟[1] 张金辉[1] 董建敏[1] 刘志宝[1] Zhang Haiyan;Zhang Yu;Guo Quanwei(Department of Ultrasound,Tangshan Maternal and Child Health Hospital,Tangshan 063000,China)

机构地区：[1]河北省唐山市妇幼保健院,063000

出　　处：《中国煤炭工业医学杂志》2020年第3期329-332,共4页Chinese Journal of Coal Industry Medicine

基　　金：2017年河北省第一批省级科技计划项目(编号:17277705D)。

摘　　要：目的探讨产前超声诊断完全性肺静脉异位引流的应用价值。方法选取2017年1月—2019年10月在我院经超声检查及产后尸体解剖确诊为完全性肺静脉异位引流胎儿25例为研究对象。将产前超声检查的结果与产后解剖结果进行分析。结果本研究中产前超声诊断完全性肺静脉异位引流胎儿共25例。其中心上型10例(40%),心下型7例(28%),心内型8例(32%)。17例(68%)合并复杂心脏畸形,8例(32%)合并单独心脏畸形。25例孕妇中4例(16%)选择继续妊娠,胎儿出生后经超声心动图证实产前诊断,21例(84%)患者选择终止妊娠,其中12例(48%)经家属同意尸检证实产前超声诊断的准确性,3例(12%)尸检结果与产前超声诊断结果不符,13例(52%)不同意进行尸检。结论超声诊断胎儿完全性肺静脉异位引流的结果可靠,有利于孕妇及家属早期做出选择,具有较好的临床应用价值。Objective To explore the value of prenatal ultrasound in the diagnosis of total abnormal pulmonary venous drainage(TAPVD).Methods From January 2017 to October 2019,twenty-five fetuses diagnosed as TAPVD by ultrasound examination and postpartum autopsy in Tangshan Maternal and Child Health Hospital were selected as the study objects.The results of prenatal ultrasound and postpartum anatomy were analyzed.Results In this study,25 fetuses with total anomalous pulmonary venous drainage were diagnosed by pre-operative ultrasound.Among them,there were 10 cases(40%)of supracardiac type,7 cases(28%)of infracardiac type,8 cases(32%)of intracardiac type,17 cases(68%)with complex cardiac malformations and 8 cases(32%)with isolated cardiac malformations.Among the 25 patients,4(16%)chose to continue pregnancy,the prenatal diagnosis was confirmed by echocardiography after birth,21(84%)chose to terminate pregnancy,12(48%)of them confirmed the accuracy of prenatal ultrasound diagnosis by autopsy with the consent of their families,3(12%)autopsy results were inconsistent with the prenatal ultrasound diagnosis results,13(52%)did not agree to autopsy.Conclusion The results of ultrasound diagnosis of fetal total anomalous pulmonary venous drainage are reliable,which is helpful for pregnant women and their families to make early choice,and has better clinical application value.

关 键 词：超声诊断 完全性肺静脉异位引流 胎儿畸形 先天性心脏病 

分 类 号：R758.73[医药卫生—皮肤病学与性病学]