应用普通黑白B超广泛性筛查胎儿先天性心脏病的临床价值

Value of Screening for Fetal Congenital Heart Diseases withBW Ultrasound

目的:应用普通黑白B超广泛性筛查胎儿先天性心脏病,并探讨其可行性及临床价值。方法:联合佛山市数家大医院B超室,应用普通黑白B超进行广泛性筛查胎儿先天性心脏病,二年总共进行23 776例筛查。主要通过多切面观察胎心大体形态、房室结构、房室瓣开闭、“十字交叉”完整性及主、肺动脉与心室连接情况等明显标致,筛查明显的胎儿先天性心脏病。异常者要用彩超复查并送其他合作医院或省级权威部门再次做彩超检查、确认,并追踪至胎儿引产或出生后,取得尸解或心脏彩超结果。结果:本组共发现单心室、心内膜垫缺损及三尖瓣闭锁并大动脉转位等严重的胎儿先天性心脏病35例。所有病例均能从二维声像图中观察到较明显的相应的结构改变。本组发现3例“假阴性”病例,可能与早期经验不多有关;早期亦曾有4例“疑似阳性”经彩超检查否定,未出现真正意义上的“假阳性”。结论:本组应用的普通黑白B超基本可提供较满意的胎儿心脏二维声像。通过培训等方法,提高超声医师对胎儿先天性心脏病检查意义的认识及检查水平,应用普通黑白B超检查广泛性筛查胎儿先天性心脏病是可行的,此举可增加胎儿先天性心脏病的检出率,对优生优育提高人口素质有着重大意义。

Objective： To investigate the possibility of screening for fetal congenital heart diseases with BW ultrasound extensively and it＇s clinical value. Methods： 9 323 cases were screened for fetal congenital heart diseases with BW ultrasound extensively by several local hospitals. All cases were observed the main structure of fetal heart with a series views. The cases that were believed with congenital heart diseases were examined by color Doppler echocardiography, and were compared with re - examination and autopsy. Results： The main structure of fetal heart was examined almost could be showed with BW ultrasound; 35 cases with severe congenital heart diseases were discovered and confirmed. This cases were all observed obvious change of structure of fetal heart. Conclusion： It＇s really possible screening for fetal congenital heart diseases with BW ultrasound extensively, as long as the doctor of ultrasound is trained for the know - how for fetal congenital heart diseases diagnosis, It＇s an important method for rising the rate of finding out fetal congenital heart diseases.