摘要
目的探讨超声心动图在胎儿单纯性室间隔缺损(isolated ventricular septal defect,i-VSD)的产前诊断、病理分型及孕期和出生后随访中的临床价值。方法对6145例胎儿超声检查中明确诊断为i-VSD的95例胎儿的心脏超声表现、病理解剖分型、遗传学检查及孕期和出生后超声随访1年的结果进行分析。结果95例i-VSD彩色多普勒显像显示心室水平双向分流,缺损大小0.9~13.4mm,平均(3.3±2.0)mm。其中膜周型60例(63.2%),肌型33例(34.7%),干下型1例(1.1%),多发1例(膜周型+肌型)。32例进行染色体检查,其中正常28例,21-三体综合征3例(9.4%),18-三体综合征1例(3.1%)。失访14例.活体出生50例,死亡5例,引产23例(尸检证实3例),未完成随访3例;50例出生后超声心动图复查与产前诊断结果一致,其中自然愈合13例(25%),手术2例,35例仍在随访观察。结论胎儿期i—VSD以单发及膜周型最常见,部分可自然愈合,对遗传学异常也具有重要提示作用;超声心动图在i-VSD的产前诊断、随访观察和治疗方案制定等方面具有重要价值。
Objective To study clinical value of echocardiography in prenatal diagnosis,classification and follow-up after birth of isolated ventricular septal defect (i-VSD). Methyls In 6145 fetuses undergoing fetal echocardiography,95 fetuses were diagnosed with i-VSD. The characteristics of fetal echocardiography, pathological classification of i-VSD, findings of genetic examination and follow-up of evolution of VSD were analyzed. Results In 95 fetuses with i-VSD,color Doppler flow imaging displayed bi-directional shunts at the ventricular level. Defect sizes ranged from 0.9 mm to 13.4mm,averaged (3.3 ± 2.0)mm. There were 60 cases (63.2%) with perimembranous i-VSD,33 cases (34.7%) with muscular i-VSD, 1 cases (1.1%) with subarterial i-VSD, 1 cases (1.1%) with muhiple i-VSD. Chromosome tests were performed successfully in 32 cases. Among these cases,there were 3 cases (9.4%) with Trisomy 21,1 case (3.12%) with Trisomy 18 and 28 cases with normal chromosomes. Among the cases, 14 were lost to follow-up,50 were life labor,5 were stillbirth,23 were induced abortion and 3 had not finished follow-up. Among 50 cases of life labor,VSD were naturally closed in 13 cases (25%) prenatally or in one year after the birth. VSD were surgically repaired in 2 cases after birth. 35 cases were still under follow-up. Conclusions Solitary and perimembranous i-VSDs were the most common types. Part of fetal i-VSDs naturally closed after birth. Prenatal i-VSD is a valuable suggestive clue for genetic abnormalities. Echocardiography has an important value in prenatal diagnosis, follow-up and treatment of VSD and may play an important role in predicting fetal genetic abnormality.
出处
《中华超声影像学杂志》
CSCD
北大核心
2013年第5期398-401,共4页
Chinese Journal of Ultrasonography
基金
陕西省科技统筹创新工程计划项目(2012KTCL03-09)
陕西省科学技术研究发展计划项目(S2010SF785)
陕西省科学技术研究发展计划项目(2012SF2-143).
关键词
超声检查
产前
室间隔缺损
染色体异常
Ultrasonography,prenatal
Heart septal defect,ventricular
Chromosome aberrations