胎儿超声三血管气管切面联合肺静脉血流频谱诊断胎儿心脏大血管畸形的临床研究  

Clinical study of fetal ultrasound three vessels trachea view combined with pulmonary venous flow spectrum in the diagnosis of fetal cardio-macrovascular malformation

作　　者：于婷芹 叶春秀 刘玮玮 蒋霞 YU Ting-qin;YE Chun-xiu;LIU Wei-wei;JIANG Xia(Department of Ultrasonography,Dezhou Maternal and Child Health Hospital,Dezhou Shandong 253100,China)

机构地区：[1]德州市妇幼保健院超声科,山东德州253100

出　　处：《局解手术学杂志》2021年第12期1072-1076,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：德州市妇幼保健院临床科学研究培育计划(DFYKY-201903)。

摘　　要：目的探讨胎儿超声三血管气管切面(3VT)联合肺静脉血流(PVF)频谱对胎儿心脏大血管畸形的诊断价值。方法回顾性分析1248名孕妇的临床资料,根据心脏大血管畸形的诊断标准,将孕妇分为正常组(1208例)和异常组(40例)。比较2组孕妇的一般资料;统计超声3VT对胎儿心脏大血管畸形的检出情况;比较2组胎儿的PVF相关参数;比较超声3VT、PVF频谱单独使用及二者联合使用对胎儿心脏大血管畸形诊断的符合率及诊断价值。结果2组孕妇年龄、家族史、既往妊娠史、妊娠期合并症、孕期使用抗生素比较,差异均具有统计学意义(P<0.05);病理检查诊断出40例心脏大血管畸形胎儿;超声3VT共检查出30例,血管管径大小异常、位置异常、数量异常的检出率分别为73.68%、80.00%和72.73%;PVF频谱共检测出28例异常胎儿,其中8例心房收缩期速度(A)波缺失(20.00%),8例A波反向(20.00%),12例PVF频谱呈连续波形改变(30.00%)。异常组胎儿的A波明显低于正常组,收缩期峰值流速(S)/A、(S-A)/舒张期峰值流速(D)、(S-A)/S明显高于正常组,差异均具有统计学意义(P<0.05);超声3VT联合PVF频谱诊断的符合率、特异度、阳性预测值明显高于3VT、PVF频谱单独诊断(P<0.05)。结论胎儿超声3VT联合PVF频谱能够明显提高胎儿心脏大血管畸形诊断的符合率和准确性,较3VT、PVF频谱单独诊断更具优势。Objective To explore the diagnostic value of fetal ultrasound three vessels trachea view(3VT)combined with pulmonary venous flow(PVF)spectrum on fetal cardio-macrovascular malformation.Methods The clinical data of 1248 pregnant women were retrospectively analyzed,they were divided into the normal group(1208 cases)and the abnormal group(40 cases)according to the diagnostic criteria of cardio-macrovascular malformation.The general data of pregnant women in the two groups were compared;the examination results of fetal cardio-macrovascular malformation by ultrasound 3VT was counted;the PVF related parameters of fetuses in the two groups were compared;the coincidence rate and diagnostic value of single use of ultrasound 3VT,PVF spectrum and combined use of them in the diagnosis of fetal cardio-macrovascular malformation were compared.Results There were statistically significant differences in age,family history,previous pregnancy history,pregnancy complications,and the use of antibiotic during pregnancy of pregnant women between the two groups(P<0.05).Pathological examination found 40 fetuses with cardio-macrovascular malformation;and ultrasound 3VT found 30 cases,whose examination rates of abnormal vessel diameter,position,and number were 73.68%,80.00%,and 72.73%,respectively;PVF spectrum found 28 abnormal fetuses,including 8 cases(20.00%)with disappeared atrial systolic velocity(A)wave,8 cases(20.00%)with reversed A wave,and 12 cases(30.00%)with continuous waveform changes of PVF spectrum.A wave of fetuses in the abnormal group was significantly lower than that in the normal group,and the ratio of peak systolic flow rate(S)/A,the ratio of(S-A)/diastolic peak flow rate(D),the ratio of(S-A)/S were significantly higher than those in the normal group,with statistically significant differences(P<0.05).The coincidence rate,specificity,and positive prediction value of combined diagnosis of ultrasound 3VT and PVF spectrum were significantly higher than those of single diagnosis of 3VT and PVF spectrum(P<0.05).Conclusion Fet

关 键 词：胎儿 三血管气管切面 肺静脉血流 心脏大血管畸形 诊断 超声 

分 类 号：R714[医药卫生—妇产科学]