胎儿静脉导管异常连接的产前超声表现及其预后随访分析  

Prenatal ultrasonographic findings and prognostic analysis in abnormal connection of fetal venous catheter.

作　　者：阳春芳 刘志辉[1] 党彩玲[1] 曾师晨 YANG Chun-fang;LIU Zhi-hui;DANG Cai-ling;ZENG Shi-chen(Department of Ultrasound,the No.2 People's Hospital of Yibin,Yibin 644004,Sichuan,CHINA)

机构地区：[1]宜宾市第二人民医院超声科,四川宜宾644004

出　　处：《海南医学》2021年第3期342-345,共4页Hainan Medical Journal

摘　　要：目的探讨胎儿先天性静脉导管异常连接的产前超声心动图表现及其对胎儿预后的影响。方法回顾性分析2010年12月至2019年12月宜宾市第二人民医院检出的8例胎儿静脉导管异常连接的超声声像图特点,观察心脏大小、功能变化,并追踪胎儿临床预后情况。结果8例静脉导管异常连接胎儿中,静脉导管直接回流入右房3例,其中1例胎儿合并心内外畸形及染色体异常,产后死亡。静脉导管连接冠状静脉窦汇入右房3例,其中1例胎儿无合并心内外畸形及染色体异常,出生时体质量低于同龄儿,余无特殊,1例胎儿孕晚期出现全身水肿及右心衰胎死宫内,1例胎儿合并心外畸形及染色体异常引产。静脉导管通过无顶冠状静脉窦汇入左房1例,静脉导管汇入门静脉1例,静脉导管直接回流入右房病例中另外2例,该4例胎儿无合并心内外畸形及染色体异常,均临床预后良好。结论单纯的静脉导管异常连接未合并心内、心外畸形且胎儿心功能无异常者,预后良好;静脉导管异常连接,若合并严重心内、心外系统畸形者或心功能不全者,预后不良。静脉导管异常连接与胎儿染色体异常有相关性,如需继续妊娠,应建议先行胎儿染色体检查,并利用超声密切随访胎儿心功能。Objective To analyze the prenatal ultrasound findings of abnormal connection of fetal venous catheter and its impact on the prognosis.Methods Ultrasonographic characteristics with abnormal connection of fetal venous catheter in 8 cases between December 2010 to December 2019 in the No.2 People's Hospital of Yibin were retrospectively analyzed.The changes of heart size and function were observed,and the clinical prognosis of fetus was followed up.Results Among the 8 cases,3 cases showed venous catheter directly connected into the right atrium,of which one was complicated with intracardiac and extracardiac malformation and chromosome abnormality and died after delivery;3 cases showed venous catheter connected to coronary sinus and then into right atrium:one case was underweight at birth and had no congenital malformation or chromosome abnormality,1 case died in late pregnancy due to general edema and right heart failure,1 case was aborted due to complication of extracardiac malformation and chromosome abnormality;1 case showed venous catheter connected to apical coronary sinus and then into left atrium;1 case showed venous catheter flowed into portal vein.The latter two cases and the remaining 2 cases with venous catheter directly connected into the right atrium had no complication of intracardiac and extracardiac malformation or chromosome abnormality and all achieved good prognosis.Conclusion The prognosis of patients with abnormal connection of venous catheters without fetal cardiac dysfunction is good.Abnormal connection of venous catheters with severe intracardiac and extracardiac system malformations of cardiac dysfunction will lead to poor prognosis.Abnormal connection of venous catheter is correlated to chromosome abnormality,and fetal chromosome examination should be conducted first and fetal cardiac function should be closely followed by ultrasound if pregnancy continued.

关 键 词：静脉导管异常连接 产前超声检查 超声心动图 染色体检查 临床预后 

分 类 号：R714.43[医药卫生—妇产科学]