宫内胎儿肺动脉瓣成形术治疗肺动脉瓣重度狭窄伴右心发育不良综合征2例  

Analysis of two fetuses with critical pulmonary valve stenosis combined with hypoplastic right heart syndrome treated with fetal pulmonary valvuloplasty

作　　者：邵泽华 韩宇 刘琳 宋书波 武海英 王睿丽 范太兵 SHAO Zehua;HAN Yu;LIU Lin;SONG Shubo;WU Haiying;WANG Ruili;FAN Taibing(Children′s Heart Center,People′s Hospital,Zhengzhou University,Zhengzhou 450003;Department of Structural Cardiology,People′s Hospital,Zhengzhou University,Zhengzhou 450003;Department of Ultrasound,People′s Hospital,Zhengzhou University,Zhengzhou 450003;Department of Obstetrics,People′s Hospital,Zhengzhou University,Zhengzhou 450003)

机构地区：[1]郑州大学人民医院儿童心脏中心,郑州450003 [2]郑州大学人民医院结构性心脏病区,郑州450003 [3]郑州大学人民医院超声科,郑州450003 [4]郑州大学人民医院产科,郑州450003

出　　处：《郑州大学学报（医学版）》2022年第1期130-135,共6页Journal of Zhengzhou University(Medical Sciences)

基　　金：河南省医学科技攻关计划项目(SBGJ2018074);河南省自然科学基金优秀青年科学基金项目(202300410364);河南省医学科技攻。

摘　　要：目的:总结重度肺动脉瓣狭窄伴右心发育不良综合征(HRHS)胎儿的宫内介入治疗。方法与结果:对郑州大学人民医院2例孕中晚期肺动脉瓣狭窄伴HRHS的胎儿,经多学科会诊、评估,分别于孕32周及孕28周实施超声引导下宫内胎儿肺动脉瓣成形术(FPV)。2例FPV术后围术期恢复良好,右心系统发育及血流动力学指标较术前明显改善,右室流出道前向血流增加。病例1产后患儿出现肺动脉瓣再狭窄,通过经皮肺动脉瓣成形术及外科手术再干预最终实现双心室循环。病例2行FPV治疗2周后,孕妇选择终止妊娠。结论:宫内FPV可促进孕中晚期肺动脉瓣狭窄伴HRHS胎儿右心系统再发育,利于产后双心室矫治。Aim:To summarize the fetal intrauterine interventional treatment for critical pulmonary stenosis(CPS)combined with hypoplastic right heart syndrome(HRHS).Methods and Results:Two fetuses with CPS combined with HRHS in middle and late pregnancy from People′s Hospital of Zhengzhou University were performed multidisciplinary consultation,then received ultrasound-guided intrauterine fetal pulmonary valvuloplasty(FPV)treatment at the 32th and 28th week of gestation,respectively.The phylogenetic and hemodynamic indexes of the right heart of the 2 fetuses were improved after FPV,and recovered well during perioperative period.In case 1,pulmonary restenosis occurred after delivery,and biventricular circulation was finally achieved through percutaneous pulmonary valvuloplasty and surgical reintervention.Case 2 terminated the pregnancy 2 weeks after FPV.Conclusion:FPV could promote the redevelopment of the right ventricular system of fetuses with CPS combined with HRHS in the middle and late pregnancy,and is helpful for postpartum biventricular correction.

关 键 词：肺动脉瓣狭窄 右心发育不良综合征 胎儿肺动脉瓣成形术 

分 类 号：R725.4[医药卫生—儿科]