一体化管理先天性心脏病胎儿预后及随访研究  

Integrated management of fetal prognosis and follow-up study of congenital heart disease

作　　者：尚坤 凌奕[2] 何桂林 许莹红 王婷 李小玲[1] 李垲烨 胡心怀 候沛宇 陈月芬 刘春桃 陈泽俊[2] 崔晓菁[2] 陈仁伟 Shang Kun;Li Xiaoling;Li Kaiye;Hu Xinhuai;He Guilin;Ling Yi;Hou Peiyu;Chen Yuefen;Liu Chuntao;Chen Zejun;Cui Xiaojing;Chen Renwei(Hainan Medical University,Haikou,Hainan 571199,China;Department of Fetal Medicine,the First Af filiated Hospital of Hainan Medical University,Haikou,Hainan 570102,China;Hainan Provincial Women and Children's Medical Center,Haikou,Hainan 570312,China)

机构地区：[1]海南医学院,海南海口571199 [2]海南医学院第一附属医院胎儿医学科,海南海口570102 [3]海南省妇女儿童医学中心,海南海口570312

出　　处：《中国产前诊断杂志(电子版)》2025年第1期1-5,共5页Chinese Journal of Prenatal Diagnosis(Electronic Version)

基　　金：2022年大学生创新课题(X202211810027);2022海南省自然科学基金(高层次人才项目),(822RC825);海南省自然科学青年基金项目(821QN404);海南省重点研发项目(ZDYF2022SHFZ121)。

摘　　要：目的探讨产前诊断、产后治疗的一体化管理先心病胎儿模式在临床实践中的指导作用及运用。方法回顾性分析自2017年至2024年于海南医学院第一附属医院、海南省儿童医院确诊先天性心脏病胎儿,选取共105例心脏结构异常胎儿,根据是否实行一体化管理先心病胎儿分为对照组和实验组,并将两组先心病胎儿进行围生期危险度评分分级,比较两组间胎儿出生后心脏情况以及临床手术情况。结果对照组共54例先心病胎儿,其中Ⅰ级1例,Ⅱ级49例,Ⅲ级3例,Ⅳ级1例,Ⅰ、Ⅱ级共50例先心病胎儿娩出后心脏情况良好;Ⅲ级先心病胎儿娩出后,1例心脏情况良好,2例接受手术,恢复良好;Ⅳ级先心病胎儿娩出后于产后3天接受手术,恢复良好。实验组共51例先心病胎儿,其中Ⅰ级9例,Ⅱ级42例,Ⅰ级9例分娩后正常未进行手术干预,Ⅱ级中40例正常未进行手术干预,2例接受手术,恢复良好。结论一体化管理先心病胎儿模式可为围生期先心病胎儿的管理提供科学、简便、高效的决策方案,为临床实践提供方向,减少不必要的引产,改善新生儿的心脏手术预后,保障母婴安全。Objective To explore the guiding role and application of the integrated management of fetal congenital heart disease in prenatal diagnosis and postpartum treatment in clinical practice.Methods A retrospective analysis of 105 fetuses with cardiac structural abnormalities diagnosed with congenital heart disease in the First Affiliated Hospital of Hainan Medical College and Hainan Children's Hospital from 2017 to 2024 was selected.According to the implementation of integrated congenital heart disease fetal management,they were divided into control group and experimental group.The perinatal risk scores of the two groups of congenital heart disease fetuses were graded,and the fetal heart conditions after birth and clinical surgery were compared between the two groups.Results There were 54 cases of congenital heart disease in the control group,including 1 case of gradeⅠ,49 cases of gradeⅡ,3 cases of gradeⅢ,1 case of gradeⅣ,and 50 cases of gradeⅠandⅡ.The heart was in good condition after delivery;after the delivery of the fetus with gradeⅢcongenital heart disease,1 case had a good heart condition,and 2 cases underwent surgery and recovered well.The fetus with gradeⅣcongenital heart disease underwent surgery three days after delivery and recovered well.There were 51 fetuses with congenital heart disease in the experimental group,including 9 cases of gradeⅠand 42 cases of gradeⅡ.9 cases of grade I were normal after delivery without surgical intervention,and 40 cases of gradeⅡwere normal without surgical intervention.2 cases underwent surgery and recovered well.Conclusion The integrated management of congenital heart disease fetus model can provide scientific,simple and efficient decision-making scheme for the management of perinatal congenital heart disease fetus,provide direction for clinical practice,reduce unnecessary induction of labor,improve the prognosis of neonatal cardiac surgery,and ensure the safety of mother and child.

关 键 词：先天性心脏病 一体化管理 胎儿 产前诊断 

分 类 号：R714.53[医药卫生—妇产科学]