心脏轴测定在胎儿先天性心脏病产前超声诊断中的临床意义

Clinical significance of cardiac axis determination of congenital heart disease in fetus prenatal ultrasound diagnosis

目的探讨心脏轴测定在胎儿先天性心脏病产前超声诊断中的临床意义。方法对2011年3月-2012年12月215例产妇进行心脏轴测定，在心脏超声四腔观基础上测定胎儿心脏轴，并从多切面观察胎儿心内结构，以确定胎儿有无先心病。结果正常组胎儿心轴角度分布为21．84°～61．7°，平均心轴角度为（41．52±7．38）。。先心病组中心轴角度分布为15．52。～91．85°，平均心轴角度为（54．09±17．94）°，两组患者左侧心轴角度比较，差异有统计学意义（P〈0．05）°正常组胎儿发生心轴左偏1例（0．53％），无心轴右偏；先心病组心轴左偏9例（36．00％），心轴右偏5例（24．00％），其余10例在正常范围内。正常组的心轴左偏发生率以及心轴右偏发生率均明显低于先心病组，差异有统计学意义（P〈0．05）。结论心脏轴测定在胎儿先心病筛查中具有重要作用，可作为一种常规测量指标。

Objective To observe the clinical significance of cardiac axis determination of congenital heart disease in fetus prenatal ultrasound diagnosis. Methods 215 cases of maternal cardiacaxis determination from March 2011 to December 2012 were collected, for determination of fetal cardiac four chamber view, on the basis of Son heart axis, and the fetal heart structure from multiple views were observed, to determine fetal have without congenital heart disease. Results The normal fetal mandrel angle was 21.84 ° -61.7 ° , average spindle angle was （41.52 7.38） ° . CHD group center axis angle was 15.52 ° -91.85 ° , average spindle angle was （54.09 ~ 17.94） ° , compared two groups of patients with left axis angle, the difference was statistically significant（P 〈 0.05）. Normal fetal mandrel left in 1 case （0.53%）, a right axis deviation; congenital heart disease group had 9 cases of the left axis deviation （36%） and 5 cases（24%） right axis deviation. The other 10 cases were in the normal range. The normal group the incidence of left and right axis deviation of thesignificant decrease in the incidence of CHD group, the difference was statistically significant（P 〈 0.05）. Conclusion Determination of cardiac axis plays an important role in screening for fetal congenital heart disease, and can be used as a routine measurementindex.