产前超声检测胎儿三尖瓣反流及其预后初探

Features and prognosis of fetal tricuspid valve regurgitation by Prenatal Ultrasound Cardiogram Examination

目的探讨胎儿三尖瓣反流原因、程度与胎儿预后的关系。方法对2009年1月至2010年9月行常规超声检查所发现的52例胎儿三尖瓣反流病例,采用节段分析法,对胎儿进行系统超声心动图检查和心外其他结构全面细致地检查。根据检查情况分先心组、非先心组、单纯反流组。观察三组胎儿三尖瓣反流的特点及其预后。结果先心组10例,其中轻度反流3例,中度以上反流7例,该组8例引产,2例存活;非先心组23例,其中轻度反流19例,中度以上反流4例,该组4例引产,19例存活;单纯反流组19例,其中轻度反流17例,中度反流2例,该组19例存活。结论胎儿三尖瓣反流的病因及反流程度与预后有关,三尖瓣反流轻中度且全身情况尚好者,预后良好;三尖瓣反流合并心内(或心外)结构严重异常者,则预后不良。

Objective：To investigate the relations between the causes and reflux extent of fetal tricuspid valve regurgitation and fetal prognosis.Methods：Segmental analysis was used in examining the heart and other structures outside the heart of 52 cases with fetal tricuspid regurgitation which were found by routine ultrasound cardiogram examination from January 2009 to September 2010 in our hospital.All cases were classified into three groups that is congenital heart disease group,non-congenital heart disease group,simple regurgitation group in the light of without other abnormalities or not.Features and prognosis of fetal tricuspid valve regurgitation in three groups were observed and analysed.Results：There are 10 patients in congenital heart disease group including 3 cases with mild regurgitation and 7 cases with moderate regurgitation,resulting in 8 cases induced abortion and 2 cases survived;There are 23 cases in non-congenital heart disease group including 19 cases with mild regurgitation and 4 cases with moderate regurgitation,resulting in 4 cases induced abortion and 19 cases survived;There are 19 cases in simple regurgitation group including 17 cases with mild regurgitation and 2 cases with moderate regurgitation,resulting in 19 cases survived.Conclusion：The cause and reflux degree of fetal tricuspid valve regurgitation are related to fetal prognosis.Mild to moderate tricuspid regurgitation accompanied with a good general condition,which the fetal prognosis is good;tricuspid regurgitation combined severe structural abnormalities inside and outside the structure of fetal heart,which the fetal prognosis is poor.