胎儿卵圆孔通道血流检测在惠州地区产前超声中的应用价值  

The value of fetal foramen ovale channel blood flow detection in prenatal ultrasound in Huizhou area

作　　者：李学娟[1] 程丽丽[2] 陆丽萍 曾静[1] LI Xuejuan;CHENG Lili;LU Liping;ZENG Jing(Department of Ultrasound Imaging,Huizhou Second Maternal and Child Health Hospital,Huizhou,Guangdong 516000,China;Department of Obstetrics and Gynecology,Huizhou Second Maternal and Child Health Hospital,Huizhou,Guangdong 516000,China)

机构地区：[1]惠州市第二妇幼保健院超声科,广东惠州516000 [2]惠州市第二妇幼保健院产科,广东惠州516000

出　　处：《广州医科大学学报》2023年第4期17-21,共5页Academic Journal of Guangzhou Medical University

基　　金：惠州市科技计划项目(2021WC0106104)。

摘　　要：目的:探讨胎儿卵圆孔通道血流检测在惠州地区产前超声中的应用价值。方法:选取2021年7月至2022年12月在惠州市第二妇幼保健院行产前胎儿心脏超声检查600例孕妇,并以在检查中首次发现卵圆孔通道血流受限征象的胎儿为观察组(n=7),另按1:10比例纳入同期孕周的健康胎儿为对照组(n=70)。比较两组影像学特征,Logistic回归分析超声心动图参数与卵圆孔通道血流受限关系,并对观察组随访至胎儿出生。结果:600例行产前超声检查的孕妇中首次发现卵圆孔通道血流受限的胎儿有7例,占1.17%。观察组中7例卵圆孔通道内径均小于3 mm,且以房间隔右向左细窄分流为主,而右心系统均不同程度扩大,其中2例出现不同程度三尖瓣反流,血流速度均>40 cm/s。Logistic回归分析显示,心胸比、RA/LA、RV/LV、MPA/AO、动脉导管最窄处内径、房间隔分流束宽、动脉导管收缩均与卵圆孔通道血流受限独立有关(P<0.05)。7例卵圆孔通道血流受限胎儿中,2例出生后因主动脉缩窄手术,2例合并染色体异常,仅3例胎儿出生后恢复正常。结论:胎儿卵圆孔通道血流检测在产前超声中具有重要的诊断及评估价值,对于早期发现卵圆孔通道血流受限的胎儿给予吸氧及选取最佳的分娩时间提供临床指导。Objective:To investigate the use of fetal foramen ovale channel blood flow detection in prenatal ultrasoun in Huizhou area.Methods:From July 2021 to December 2022,600 pregnant women underwent prenatal fetal cardiac ultrasound at the Second Maternal and Child Health Hospital in Huizhou City,and the fetuses with the first sign of restricted blood flow in the foramen ovale channel during ultrasound were selected as the observation group(n=7),and the healthy fetuses at the same gestational week were included as the control group(n=70)in a ratio of 1∶10.The imaging characteristics of the two groups were recorded and compared,and the relationship between echocardiographic parameters and blood flow restriction in the foramen ovale channel was analyzed by logistic regression,and the observation group was followed up until fetal birth.Results:Restricted blood flow in the foramen ovale channel was detected for the first time in 7(1.17%)of 600 pregnant women who underwent antenatal ultrasound.In the observation group,the internal diameter of the foramen ovale channel was less than 3 mm in 7 cases,and the narrow right-to-left shunt of the interatrial septum was predominant,while the right heart system was enlarged to varying degrees,and 2 cases showed varying degrees of tricuspid regurgitation,and the blood flow velocity was>40 cm/s.Logistic regression analysis showed that cardiothoracic ratio,RA/LA,RV/LV,MPA/AO,internal diameter at the narrowest part of the arterial duct,septal shunt bundle width,and arterial duct constriction were independently associated with restricted blood flow in the foramen ovale channel(P<0.05).Of the 7 fetuses with restricted blood flow through the foramen ovale,2 were operated for aortic constriction after birth,2 had combined chromosomal abnormalities,only 3 recovered to normal after birth.Conclusion:Fetal oval foramen ovale flow detection is an important diagnostic and assessment value in prenatal ultrasound,which provides clinical guidance for early detection of fetuses with restricted oval f

关 键 词：卵圆孔通道 血流检测 超声检查 胎儿 产前 

分 类 号：R445.1[医药卫生—影像医学与核医学]