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目的:探讨并建立胎儿心脏超声的“顺序分段法”以提高宮内先天性心脏病(先心病)诊断的准确率。方法:首先确定心脏位置及心胸比例,将胎儿心脏分为4个节段(心房、心室、大血管及血管交叉、主动脉弓和动脉导管弓)筛查及诊断先心病,同时对每例胎儿进行外周动、静脉多普勒血流检测,评价先心病对外周血流动力学及胎儿生长发育的影响。结果:1450例胎儿中检出先心病42例,其中复杂性心血管畸形17例、心功能降低13例、5例胎儿水肿及大量心包积液,合并心律失常7例,外周血流搏动指数(PI)与正常组比对照组有显著差异(P<0.01)。结论:胎儿心脏超声“顺序分段法”适用于胎儿先心病的检测,可明显提高先心病的检出率及诊断准确率,特别有利于在产前低危人群中的筛查。
Objective: To investigate and establish “sequential segmentation” of fetal heart ultrasound to improve the diagnostic accuracy of intrauterine congenital heart disease (CHD). Methods: Firstly, the heart position and the ratio of heart and chest were determined. The fetal heart was divided into 4 segments (atrium, ventricle, large blood vessel and vascular cross, aortic arch and arterial catheter arch) to screen and diagnose CHD. At the same time, The arterial and venous Doppler flowmetry was used to evaluate the effect of congenital heart disease on peripheral hemodynamics and fetal growth and development. Results: Forty-two cases of congenital heart disease were detected in 1450 fetuses, including 17 cases of complicated cardiovascular malformations, 13 cases of decreased cardiac function, 5 cases of fetal edema and a large amount of pericardial effusion, and 7 cases of arrhythmia. The peripheral blood flow index PI) and normal group than the control group were significantly different (P <0.01). Conclusion: Fetal heart ultrasound “sequential segmentation method” is suitable for detecting fetal congenital heart disease, can significantly improve the detection rate of congenital heart disease and diagnostic accuracy, especially for prenatal screening of low-risk populations.