产前超声心动图诊断胎儿左心发育不良综合征合并主动脉或圆锥动脉干发育异常的临床研究  

Clinical study of prenatal ultrasound diagnosis of fetal hypoplastic left heart syndrome with aortic or conotruncal dysplasia

作　　者：颜华英[1] 张春国 何丽红 王泓力 赵婧[1] 何冠南[1] 杨家翔[1] YAN Huaying;ZHANG Chunguo;HE Lihong;WANG Hongli;ZHAO Jing;HE Guannan;YANG Jiaxiang(Department of Ultrasound,Sichuan Prowincial Maternity and Child Health Care Hospital,Chengdu Sichuan 610041,P.R.China)

机构地区：[1]四川省妇幼保健院超声医学科,四川成都610041

出　　处：《中国计划生育和妇产科》2020年第12期78-80,84,I0003,共5页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的探讨应用产前超声心动图诊断左心发育不良综合征(hypoplastic left heart syndrome,HLHS)合并主动脉或圆锥动脉干发育异常的临床研究。方法回顾性分析2017年1月至2019年6月于四川省妇幼保健院超声医学科行产前胎儿超声心动图检查诊断为HLHS 52例胎儿的临床情况。结果52例产前超声心动图诊断HLHS的胎儿均为I型(二尖瓣狭窄+主动脉瓣狭窄),其中16例(30%)为单纯型HLHS,36例(70%)为非单纯型(合并除HLHS外的畸形)。36例非单纯型HLHS中合并主动脉缩窄11例(21%),圆锥动脉干发育异常6例(11%),其中包括右室双出口3例(6%)、永存动脉干2例(3%)、完全型大动脉转位1例(2%),另19例非单纯型HLHS合并有室间隔缺损、永存左上腔静脉、单心房及下腔静脉离断等。结论胎儿诊断为HLHS的同时常合并有主动脉或圆锥动脉干发育异常的可能性,对诊断HLHS的胎儿产前超声心动图检查应重点观察主动脉和圆锥动脉干,以防漏诊。Objective To explore the clinical application of prenatal ultrasound diagnosis of fetal hypoplastic left heart syndrome(HLHS)with aortic or conotruncal dysplasia.Methods A retrospective analysis of the clinical conditions of 52 fetuses with HLHS diagnosed by prenatal fetal echocardiography in the Department of Ultrasound Medicine of Sichuan Provincial Maternity and Child Health Care Hospital from January 2017 to June 2019.Results 52 fetuses diagnosed with HLHS by prenatal echocardiography were all type I(mitral valve stenosis+aortic stenosis),of which 16 cases(30%)were simple HLHS,36 cases(70%)were non-simple(with deformity other than HLHS).Among 36 cases of non-simple HLHS,there were 11 cases(21%)with aortic dysplasia,and 6 cases(11%)with conotruncal dysplasia,including 3 cases(6%)with right ventricular double outlet,2 cases(3%)with permanent artery stem,1 cases(2%)with complete transposition of great artery,other 19 cases of non-simple HLHS had ventricular septal defeces,persistent left superior vena cava,single atrium and inferior vena cava disconnection.Conclusion The fetus diagnosed with HLHS is often accompanied by the possibility of abnormal development of the aorta or conical artery.Prenatal echocardiography for the diagnosis of HLHS should focus on the aorta and conical artery to prevent missed diagnosis.

关 键 词：胎儿左心发育不良综合征 产前超声心动图 主动脉发育异常 圆锥动脉干发育异常 

分 类 号：R714.53[医药卫生—妇产科学]