不同类型胎儿心律失常的产前超声影像学特征及出生结局  

Prenatal ultrasound imaging characteristics and birth outcomes of different types of fetal arrhythmias

作　　者：王睿婕 解艳华 缑灵山 董秀娟 许瑶璇 WANG Ruijie;XIE Yanhua;GOU Lingshan;DONG Xiujuan;XU Yaoxuan(Department of Ultrasound,Xuzhou Maternal and Child Health Hospital Affiliated to Xuzhou Medical University,Jiangsu Province,Xuzhou221009,China;Department of Genetic Medicine Center,Xuzhou Maternal and Child Health Hospital Affiliated to Xuzhou Medical University,Jiangsu Province,Xuzhou221009,China)

机构地区：[1]徐州医科大学附属徐州妇幼保健院超声科,江苏徐州221009 [2]徐州医科大学附属徐州妇幼保健院遗传医学中心,江苏徐州221009

出　　处：《中国当代医药》2023年第7期117-121,共5页China Modern Medicine

摘　　要：目的探讨胎儿心律失常产前超声诊断及产后出生结局,总结苏北地区胎儿心律失常的发生率、分析不同类型胎儿心律失常合并畸形及预后情况。方法回顾性分析2016年1月至2021年4月在徐州市妇幼保健院34172例行胎儿超声心动图检查胎儿,选取超声诊断为胎儿心律失常的661例为研究对象,分析心律失常胎儿的M型和多普勒超声心动图特征并随访胎儿出生结局,对胎儿心律失常的发生率、伴发畸形及转归情况进行统计学分析。结果34172例胎儿中共检出心律失常661例,总发生率为1.93%。其中不规则心律失常457例,构成比为69.14%;快速型心律失常137例,构成比为20.73%;慢速型心律失常67例,构成比为10.13%。661例心律失常胎儿中13例发生不良妊娠结局,发生率约1.97%,均为持续性快速型或持续性缓慢型。不同类型心律失常伴发畸形率的组间比较差异有统计学意义(χ^(2)=9.087,P=0.011)。结论产前超声可以诊断大部分胎儿心律失常并细化分型,胎儿心律失常多数结局良好,持续性快速型及持续性缓慢型心律失常的胎儿结局不良发生率明显增加。Objective To investigate the prenatal ultrasound diagnosis of fetal arrhythmias and postnatal birth outcomes.And to summarize the incidence of fetal arrhythmias and analyze the different types of fetal arrhythmias combined with malformations in northern Jiangsu Province.Methods Reviewing 34172 fetuses undergoing fetal echocardiography at Xuzhou Maternal and Child Health Hospital from January 2016 to April 2021,and 661 cases diagnosed with arrhythmias by ultrasound were selected for the study.The M-mode and Doppler echocardiographic features of the arrhythmia fetuses were retrospectively analyzed and the fetuses were followed up for birth outcomes.The incidence of fetal arrhythmias,concomitant malformations and regression were statistically analyzed.Results A total of 661 arrhythmias were detected in 34172 fetuses,with an overall incidence of about 1.93%.There were 457 irregular arrhythmias(69.14%),137 tachyarrhythmias(20.73%),and 67 slow arrhythmias(10.13%).The incidence of adverse pregnancy outcomes was approximately 1.97%in 13 of 661 arrhythmia fetuses,all of which were persistently tachycardic or persistently slow.The difference in the rate of malformations associated with different types of arrhythmias was statistically significant(χ^(2)=9.087,P=0.011).Conclusion The majority of fetal arrhythmias can be diagnosed and subtyped based on prenatal ultrasound imaging features.Most fetal arrhythmias have good outcomes,and the incidence of poor fetal outcomes is significantly higher in persistent tachyarrhythmias and persistent bradyarrhythmias.

关 键 词：胎儿 产前 心律失常 超声心动图 畸形 

分 类 号：R445.1[医药卫生—影像医学与核医学]