超声心动图诊断胎儿单纯肌部室间隔缺损及生后12个月内自然转归  

Echocardiographyic Diagnosis of Muscular Ventricular Defect in Fetal Period and Follow-up during the First Postnatal 12 Months

作　　者：张涵[1] 裴金凤[1] 杨娅[1] 马宁[1] 栾姝蓉[1] 李嵘娟[1] 李宜嘉 

机构地区：[1]首都医科大学附属北京安贞医院超声心动图一部,北京市100029

出　　处：《中国超声医学杂志》2015年第5期422-425,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨超声心动图诊断胎儿单纯肌部室间隔缺损(M-VSD)及其出生后12个月内自然转归情况。方法综合利用二维超声及多普勒技术对胎儿心脏进行检查,如观察到肌部室间隔存在分流且不存在复杂心脏畸形及其他器官重大畸形者计人观察组内,并对此部分胎儿生后进行超声心动图随访。结果诊断为单纯M-VSD胎儿24例,其中单发M-VSD 22例,多发M-VSD 2例。成功随访新生儿20例,其中单发MVSD 18例,多发M-VSD 2例;宫内自然闭合者4例,出生后闭合者9例,出生后仍然存在分流者7例(包括2例出生后初期存在分流而后期闭合者)。结论胎儿单纯M-VSD在中晚孕及出生后12个月内存在较高自然闭合率。超声心动图是诊断胎儿单纯M-VSD的可靠手段,对观察M-VSD发展和判断预后有重要意义。Objective To evaluate the application of echocardiography in diagnosing muscular ventricular septal defect(M-VSD) in fetal period and to observe the development of M-VSD during the first postnatal 12 months.Methods 2D echo and Doppler technology were used to screen the fetuses with M-VSD and follow-up was performed during first 12 months after their birth.M-VSD with complicated congenital heart diseases were excluded.Results Totally 24 M-VSD fetuses were included during January 2012 to January 2014,which was established as solitary MVSD in 22 cases and as multiple M-VSD in 2 cases.20 neonates were successfully follow-up,of whom there were 18 single M-VSD and 2 multiple M-VSD.Spontaneous closure of M-VSD in uterus and after birth was observed in 4 fetuses and 9 neonates,respectively.Shunt between ventricles existed persistently in 7 cases including 2 cases with delayed closure.Conclusions Spontaneous closure of M-VSD could occur in uterus and after birth.Echocardiography was proven to be a useful tool to follow up the development of M-VSD.

关 键 词：超声心动图 胎儿 肌部室间隔缺损 

分 类 号：R540.45[医药卫生—心血管疾病] R714.5[医药卫生—内科学]