胎儿心脏四腔切面在产前筛查心脏病中的临床价值

Clinical applied value of fetal heart four chamber view for the screen of prenatal fetal congenital heart disease

目的 :探讨胎儿心脏四腔切面在产前筛查胎儿心脏病中的临床应用价值。方法 :采用彩色多普勒超声随机对孕 2 4～ 4 2周 80 0 0例孕妇常规行胎儿心脏四腔切面检测 ,发现胎儿心脏异常者 ,由专人做完整的、多切面胎儿心动图检查 ,并提示客观的超声诊断。结果 :产前检出胎儿心脏病 36例 ,检出率为 4 .5‰ (36 / 80 0 0 ) ,18例经引产后尸体解剖证实 ,产后彩色多普勒超声证实 18例 ,其中 32例在心脏四腔切面发现异常 ,占 88.89% (32 / 36 ) ,产前检查无异常的胎儿中 ,产后发现胎儿心脏病 4例。结论 :胎儿心脏四腔切面能显示大多数胎儿心脏病的直接或间接的异常声像图表现 ,对产前筛查胎儿心脏病具有重要临床应用价值 ;其探测方法简单、易于掌握。

Objective:To explore the clinical value of fetal heart four chamber view for the screen of prenatal fetal congenital heart disease(CHD).Methods:8000 cases of fetuses were routinely and randomly examined fetal heart four chamber view with Color Doppler Ultrasound.Professional doctors performed integrated Fetal Echocardogram for fetuses who had abnormal heart four chamber view and made the diagnosis.Results:36 cases of fetal CHD were diagnosed and the detecting rate was 4.5‰ (36/8000).18 cases were confirmed by fetal autopsy after induction of labor.18 cases were confirmed by postnatal echocardiography.32 cases had abnormal four chamber view,and the rate was occupied 88.89%.4 cases were diagnosed CHD after birth in the fetuses with normal echocardiogram.Conclusion:The fetal heart four chamber view can indicate the direct or indirct abnomal sonogram of the most fetal CHD,and has important clinical value for the screen and diagnosis of prenatal CHD.The way of exploration is easy to mastery and convenient for clinic applying.