左心发育不良综合征的鉴别诊断与预后分析  

The Differential Diagnosis and Prognosis of Hypoplastic Left Heart Syndrome

作　　者：满婷婷[1] 何怡华[1] 孙琳[1] 张烨[1] 刘晓伟[1] 韩建成[1] 

机构地区：[1]北京市 首都医科大学附属北京安贞医院超声科 胎儿心脏病母胎医学实验室,100029

出　　处：《中国超声医学杂志》2015年第8期708-711,共4页Chinese Journal of Ultrasound in Medicine

基　　金：胎儿心脏病母胎医学北京市重点实验室(No.BZ0308);教育部重点实验室(No.PXW2014_014226_000012);国家科技支撑计划(No.2014BAI08B07)

摘　　要：目的通过对比分析胎儿左心偏小病例,探讨胎儿左心发育不良综合征(HLHS)的超声特点,进行准确诊断与鉴别诊断,为进行合理预后咨询提供依据。方法对产前超声心动图检出的280例左心偏小的超声图像进行回顾性分析,与尸检或出生后超声结果对比分析其预后特点,并对其病因进行鉴别。结果 280例左心偏小病例中,HLHS 26例,主动脉缩窄95例,卵圆孔血流受限30例,肺静脉畸形引流6例,右室双出口51例,永存左上腔静脉32例,生理性右心优势13例,非对称性房室间隔缺损27例。HLHS与其他左心偏小疾病的主要鉴别点为,二尖瓣及主动脉瓣狭窄或闭锁;左心可小也可球形扩张,但左心功能减低,心尖由右室构成。结论产前超声心动图早期诊断HLHS,并与其他引起左心偏小的疾病进行鉴别,对其预后判断及胎儿围产期管理意义重大。Objective To discuss the echocardiography characteristic in diagnosis and differential diagnosis of hypoplastic left heart syndrome(HLHS)through comparison and analysis of the cases of small left heart,and provide some basis for reasonable prognosis consulting.Methods Prenatal echocardiographic images of 280 cases of small left heart were analyzed for differential diagnosis of cause.And its prognosis was analyzed comparison with the autopsy or postnatal echocardiography results.Results In 280 cases of small left heart,26 were HLHS,95 were coarctation of aortic,30 were foramen ovale restriction,6were anomalous pulmonary venous connection,51 were double outlet right ventricle,32 were persistent left superior vena cava,13 were physiological right heart advantage,27 were asymmetry atrial-ventricular septal defect.The major differential points of HLHS as follow,mitral valve and aortic valve stenosis or atresia,small left heart or spherical dilatation,lower left heart function,the apex of right ventricle.ConclusionsIt has great significant for prognosis and perinatal periodmanagement of HLHS based on early diagnosis in prenatal echocardiography and differential diagnosis with other small left heart.

关 键 词：胎儿超声心动图 左心发育不良综合征 鉴别诊断 预后 

分 类 号：R714.5[医药卫生—妇产科学] R540.45[医药卫生—临床医学]