早孕晚期胎儿严重心脏畸形的超声诊断研究  

Ultrasonic diagnosis of severe fetal severe cardiac malformations in later period of early pregnancy

作　　者：王常松 WANG Chang-song(Shenyang Maternal and Child Health Hospital,Shenyang 110000,China)

机构地区：[1]沈阳市妇幼保健院,110000

出　　处：《中国现代药物应用》2022年第18期73-75,共3页Chinese Journal of Modern Drug Application

基　　金：沈阳市卫生健康委科研课题计划项目(项目编号:2020072)。

摘　　要：目的探讨早孕晚期胎儿严重心脏畸形的超声诊断效果。方法300例早孕晚期孕妇,均行经腹二维超声、三维彩色多普勒超声筛查。以产后诊断为金标准,分析产后诊断结果、早孕晚期超声胎儿心脏畸形诊断符合率以及诊断效果。结果300例产妇产后超声诊断显示严重胎儿心脏畸形55例(18.33%),其中法洛氏四联症8例,完全性心内膜垫缺损6例,心脏外翻5例,严重室间隔缺损10例,单心室/心腔6例,右室双出口6例,完全性大动脉转位4例,永存动脉干4例,肺动脉瓣闭锁3例,左心室发育不良3例;另确诊室间隔缺损(非严重胎儿心脏畸形)14例(4.67%);严重胎儿心脏畸形占比18.33%高于非严重胎儿心脏畸形的4.76%。早孕晚期超声诊断显示:共检出严重胎儿心脏畸形51例,诊断符合率为92.73%(51/55);共检出非严重胎儿心脏畸形(室间隔缺损)16例,诊断符合率为87.50%(14/16);早孕晚期超声检测胎儿心脏畸形诊断符合率为94.20%(67/69)。早孕晚期超声对胎儿心脏畸形诊断灵敏度为94.20%(65/69),特异度为99.13%(229/231),诊断准确率为98.00%(294/300)。结论早孕晚期超声诊断可有效发现胎儿心脏畸形,并为下一步检查与处理提高重要参考价值,临床诊断准确性较高,可有效降低心脏畸形患儿出生率。Objective To discuss the effect of ultrasound in diagnosis of severe fetal severe cardiac malformations in later period of early pregnancy.Methods 300 pregnant women in later period of early pregnancy underwent transabdominal two-dimensional ultrasonography and three-dimensional color Doppler ultrasonography.The postnatal diagnosis was used as a gold standard to analyze the results of postnatal diagnosis,the diagnostic compliance rate of fetal cardiac malformation by ultrasound in later period of early pregnancy,and the diagnostic effect.Results Postnatal ultrasound diagnosis in 300 mothers showed 55 cases(18.33%)of severe fetal cardiac malformations,including 8 cases of tetralogy of Fallot,6 cases of complete endocardial cushion defect,5 cases of cardiac ectopy,10 cases of severe ventricular septal defect,6 cases of single ventricle/chamber,6 cases of double outlet right ventricle,4 cases of complete transposition of the great arteries,4 cases of permanent arterial trunk,3 cases of pulmonary valve atresia and 3 cases of left ventricular dysplasia.Another 14 cases(4.67%)of ventricular septal defect(non-severe fetal cardiac malformation)were confirmed;the percentage of severe fetal cardiac malformation(18.33%)was higher than that of non-severe fetal cardiac malformation(4.76%).Ultrasound diagnosis in later period of early pregnancy showed that 51 cases of severe fetal cardiac malformations were detected,with a diagnostic compliance rate of 92.73%(51/55);16 cases of non-severe fetal cardiac malformations(ventricular septal defect)were detected,with a diagnostic compliance rate of 94.20%(67/69).The diagnostic compliance rate of fetal cardiac malformations detected by ultrasound in later period of early pregnancy was 87.50%(14/16).The diagnostic sensitivity of fetal cardiac malformations detected by ultrasound was 94.20%(65/69),the specificity was 99.13%(229/231),and the diagnostic accuracy was 98.00%(294/300).Conclusion Ultrasound diagnosis in later period of early pregnancy can effectively detect fetal cardiac malf

关 键 词：二维超声 三维超声 早孕晚期 胎儿心脏 严重畸形 灵敏度 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.53[医药卫生—诊断学]