静脉导管的多普勒血流流速曲线在筛选胎儿先天性心脏病中的临床意义  

Clinical significance of Doppler flow waveform of ductus venosus in screening for fetal cardiac malformation

作　　者：张静[1] 周启昌[1] 刘明辉[1] 范平[1] 云正芬[1] 章鸣[1] 彭清海[1] 龙湘党[1] 邹勤[1] 

机构地区：[1]中南大学湘雅二医院超声诊断科,长沙410011

出　　处：《中华超声影像学杂志》2003年第3期158-161,共4页Chinese Journal of Ultrasonography

摘　　要：目的　探讨静脉导管的血流流速曲线在筛选和协助早期诊断胎儿先天性心脏病中的临床意义。方法　应用彩色多普勒超声诊断系统检测 2 40例 14～ 41孕周的正常胎儿和 2 0例先天性心脏病胎儿的静脉导管血流流速曲线 ,并计算静脉导管血流阻力指数、搏动指数及心室收缩期峰值速度与心房收缩期最大流速比值。结果　①正常胎儿静脉导管的血流流速曲线呈特殊的波形 :心室收缩期波峰S、心室舒张期波峰D和心房收缩期波谷A ,前向血流持续整个心动周期 ;② 2 0例先天性心脏病胎儿中 8例静脉导管的A波出现反转 ,9例A波降低或缺失 ,3例无明显变化。先天性心脏病胎儿组静脉导管血流指数较胎龄相匹配的正常胎儿组增高 ,两组比较差异有显著性意义 (P <0 .0 5 )。结论　彩色多普勒超声检测胎儿静脉导管的血流流速曲线可筛选或协助早期诊断胎儿先天性心脏病。Objective To investigate the clinical significance of Doppler flow waveform of ductus venosus (DV) in screening of fetal cardiac malformation.Methods Color Doppler ultrasonography was used to study DV flow in 240 normal fetuses and 20 fetuses with cardiac malformation that were screened out from the high-risk fetuses with congenital heart disease (CHD).Results ① The normal Doppler flow waveform of the DV was a characteristic triphasic pattern with forward flow during cardiac cycle,reflecting ventricular systole (S),ventricular diastole (D) and atrial systole (A).② In the group of 20 fetuses with cardiac malformation,eight had reverse flow and nine had decreased or absent flow during atrial contraction,the indices of the DV in fetuses with cardiac malformation were higher than those in gestational age-matched normal fetuses ( P < 0.05 ).Conclusions Doppler ultrasonographic detection of DV blood flow will be useful as a new prospective technique in screening of fetal cardiac malformation.

关 键 词：多普勒超声检测 先天性心脏缺损 静脉导管 胎儿 

分 类 号：R445.1[医药卫生—影像医学与核医学]