超声四腔心头侧偏转法及顺序节段分析法诊断中孕期胎儿先天性心脏病的临床价值

Clinical value of four-chamber view cephalic deviation method and sequential segmental analysis method in the diagnosis of fetal congenital heart disease in middle pregnancy

目的探讨超声四腔心头侧偏转法及顺序节段分析法在中孕期胎儿先天性心脏病诊断中的临床价值。方法选取2011年5月～2012年5月来我院进行产前筛查的9050例孕妇为临床研究对象。对所有孕妇先采用超声四腔心头侧偏转法进行产前筛检，对可疑的患者再联合顺序节段分析法进行筛检，对诊断结果与随访产后超声检查及尸检结果进行比较分析。结果产后超声检查及尸检检出60例CHD患儿．其中复杂性CHD32例。检出节段畸形72处。四腔心头侧偏转法及顺序节段分析法联合检测出CHD及复杂性CHD分别为57例、32例，对CHD及节段畸形诊断敏感性分别为95．0％、93．1％，敏感性均较单独四腔心头侧偏转法高，漏诊人数少．差异具有统计学意义（P〈0．05）。四腔心头侧偏转法及顺序节段分析法两种方法联合检测的诊断结果与产后超声检查及尸检结果较为一致（P〉0．05）。结论四腔心切面头侧偏转法及顺序节段分析法简单、快速、可靠，是行之有效的胎儿心脏畸形筛查方法，应用价值显著，值得在临床上广泛推广。

Objective To study the clinical value of four-chamber view cephalic deviation method and sequential seg- mental analysis method in the diagnosis of fetal congenital heart disease in middle pregnancy. Methods A total of 9 050 pregnant women admitted in our hospital for prenatal screening from May 2011 to May 2012 were seleted as the object of study. All pregnant women were detected by four-chamber view cephalic deviation method for prenatal screening, and the patients with suspect were detected by sequential segmental analysis method, then the diagnostic results were compared with postpartum ultrasound and autopsy results. Results Sixty cases of children with CHD were detected by postpartum ultrasound and autopsy, including 32 complexity CHD, and section deformity in 72 places. Four-chamber view cephalic deviation method and sequential segmental analysis method detected 57 cases of CHD and 32 cases of complexity CHD, the diagnostic sensibility of CHD and section deformity were 95.0%, 93.1% respectively, the sensibil- ity was better than four-chamber view cephalic deviation method lonely, the number of missed diagnosis was less, there were significant difference （P〈0.05）. The diagnostic results of four-chamber view cephalic deviation method and sequen- tial segmental analysis method were consistent with postpartum ultrasound and autopsy results （P〉0.05）. Conclusion Four-chamber view cephalic deviation method and sequential segmental analysis method are simple, fast, reliable and effective methods in the diagnosis of fetal congenital heart disease,have remarkable application value and worthy of widely popularization.