胎儿动脉导管狭窄及闭合12例临床分析  

Fetal ductus arteriosus stenosis and closure:12 cases study

作　　者：张佳 温立娜 王成书[1] ZHANG Jia;WEN Li-na;WANG Cheng-shu(Department of Obstetrics and Gynecology,The Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院产科,河北石家庄050000

出　　处：《中国实用妇科与产科杂志》2024年第9期957-960,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：河北省省级科技计划资助(182777224)。

摘　　要：目的探讨胎儿动脉导管狭窄及闭合的预后,为临床处理提供依据。方法回顾性分析河北医科大学第二医院2014—2022年收治的12例胎儿动脉导管狭窄及闭合病例的超声心动图表现、临床处理及新生儿早期预后,复习国内外相关文献,探讨该病的临床处理方案。结果12例胎儿动脉导管狭窄及闭合病例的主要超声心动图表现:动脉导管收缩期血流速度增加或无血流通过,三尖瓣反流,右心扩大,右心室壁肌增厚等。其中9例胎儿动脉导管狭窄者8例新生儿早期预后良好,3例胎儿动脉导管闭合者2例新生儿早期预后良好。结论胎儿动脉导管狭窄及闭合的新生儿预后与胎儿心脏受损程度、终止妊娠孕龄及病因有关,胎儿心脏失代偿之前,可在密切观察下延长孕龄,大部分新生儿预后良好。此外,对于妊娠中晚期接触非甾体抗炎药物的孕妇应监测胎儿动脉导管情况。Objective To analyze the prognosis of fetal ductus arteriosus stenosis/closure,and provide basis for clinical treatment.Methods Retrospective analysis echocardiographic findings,clinical management,and early neonatal prognosis of 12 cases of fetal ductus arteriosus stenosis/closure admitted to the Second Hospital of Hebei Medical University from 2014 to 2022,combining with domestic and foreign literature research,to discuss the clinical treatment.Results 12cases of fetal ductus arteriosus stenosis/closure mainly manifested as increased or disappearance of the systolic blood flow of the ductus,increased three tricuspid regurgitation,dilation of the right heart,thickening of the right ventricular in our hospital.Among the 9 cases with fetal ductus arteriosus stenosis,8 cases had a good neonatal outcome.The prognosis of 2 of the 3 cases with fetal ductus arteriosus closure was good.Conclusions The neonatal prognosis of fetal ductus arteriosus stenosis/closure is related to the degree of fetal heart damage,gestational age and etiology.Before fetal heart decompensation,the gestational age can be prolonged under close observation,and most newborns have a good prognosis.In addition,pregnant women exposed to NSAIDs in the second and third trimester of pregnancy should be monitored for fetal arterial duct.

关 键 词：动脉导管收缩 动脉导管闭合 胎儿 非甾体抗炎药 

分 类 号：R714.5[医药卫生—妇产科学]