节段分析法在胎儿先天性心脏病超声诊断中的临床应用

Sequential segmental analysis by cardiac ultrasonography in fetal congenital heart disease

目的探讨节段分析法（segmentalanalysis）在胎儿先天性心脏病（CHD）超声诊断中的临床应用价值。方法回顾性分析2010年6月至2011年11月应用节段性分析法超声检查出的26例心脏畸形胎儿，其中简单型先天性心脏病（室间隔缺损、房间隔缺损）10例，复杂型先天性心脏病16例。结果26例心脏畸形胎儿中，出生后彩超证实5例（室间隔缺损4例、房间隔缺损1例），误诊1例（产前诊断为膜周型室间隔缺损，产后彩超证实为右冠状动脉右室瘘），其余心脏畸形胎儿经随访及省级医院超声复查证实后作引产处理。结论节段分析法在胎儿心脏超声检查中能系统地分析心脏结构异常，对于提高简单型先天性心脏病诊断准确度价值不大，对于复杂型先天性心脏病能提供更准确、更完善的诊断结果，对于妊娠筛选及产后干预有重要临床指导意义。

Objective To explore the clinical value of segmental analysis in fetal congenital heart disease （CHD）. Methods A retrospective analysis of 2010 June to 2011 November using segmental analysis of ultrasonography of fetal cardiac malformation in 26 cases, in which simple CHD （VSD, ASD） in 10 cases, complex CHD in 16 cases. Results 26 cases of cardiac malformation fetus, birth color Doppler ultrasound was confirmed in 5 cases （4 cases of VSD, ASD in 1 cases）, 1 cases were misdiagnosed （prenatal diagnosis for perimembranous VSD, postpartum ultrasonography confirmed right coronary artery to right ventricular fistula）, other cardiac malformation fetus after a follow-up of provincial hospitals and ultrasonic examination confirmed after induction treatment. Conclusion Segmental analysis in the ultrasonic examination of fetal heart to systematic analysis of abnor- mal cardiac structure, can improve the simple CHD diagnosis accuracy of little value, for complex CHD can provide more accurate and better diagnosis, screening for pregnancy and postpartum intervention has important clinical significance.