应用二维超声心动图广泛性筛查胎儿先天性心脏病的临床价值

Value of creening for fetal congenital heart diseases with two dimensional echocardiogram extensively

目的:探讨应用二维超声心动图广泛性筛查胎儿先天性心脏病的可行性及临床价值。方法:联合佛山市数家大医院B超室,应用二维超声心动图进行广泛性筛查胎儿先天性心脏病,3年总共进行26786例筛查。主要通过多切面观察胎心位置、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示,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:本组筛查基本上能获得较满意的胎儿心脏二维声像,胎心结构清楚。总共发现单心室、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77例。所有病例均能观察到较明显的相应的结构改变的二维声像。本组发现16例“假阴性”病例,可能与早期经验不多有关。未出现真的“假阳性”病例。结论:较新型的二维超声心动图仪基本可提供较满意的胎儿心脏二维声像。只要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,应用二维超声心动图广泛性筛查胎儿先天性心脏病是可行的,对提高胎儿先天性心脏病的检出率及支持优生优育政策的推行有着重大意义。

Objective： To investigate the possibility of screening for fetal congenital heart diseases with Two Dimensional Echocardiogram extensively and its clinical value. Methods： 26 786 eases were screened for fetal congenital heart diseases with Two Dimensional Eehocardiogram extensively by several local hospitals. All eases were observed the main structure of fetal heart with a series views. The eases which were believed in congenital heart diseases were examined by color Doppler eehocardiography, and were compared with re - examination and autopsy. Results： The main structure of fetal heart was examined almost could be showed with Two Dimensional Eehoeardiogram; 84 cases with severe congenital heart diseases were discovered and confirmed. This eases were all observed with obvious change of structure of fetal heart. Conclusion： It＇s really possible screening for fetal congenital heart diseases with Two Dimensional Eehocardiogram 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.