彩色多普勒超声对胎儿先天性心脏病的筛查现状

Current Situation of Screening of Color Doppler Ultrasound in Diagnosis of Fetal Congenital Heart Disease

先天性心脏病是一种常见的出生缺陷,居人类先天缺陷的首位,给家庭和社会带来了沉重负担,因此对其进行产前诊断极其重要。目前先天性心脏病的产前诊断主要通过两种途径,即超声检查及遗传学检查。超声检查的方法主要通过对胎儿早孕期及中晚孕期的筛查完成,从而判断胎儿是否存在先天性心脏病的可能。在孕期筛查包括:测量胎儿颈项透明层(nuchal translucency,NT)厚度、采集静脉导管血流频谱、三尖瓣反流、心脏结构扫查、时间-空间关联成像(STIC)技术的应用;中晚孕期筛查包括:腹部横切面、四腔心切面、左右室流出道长轴切面、三血管-气管切面、大动脉短轴切面、上下腔静脉长轴切面、主动脉弓长轴切面、动脉导管长轴切面等切面进行扫查。现就目前胎儿先天性心脏病的产前诊断在超声方面的开展现状情况作一综述,使胎儿先天性心脏病得到更有效的诊断,对产前优生选择、产后新生儿得到及时救治及提高人口出生素质等具有非常重要的意义。

Congenital heart disease is a common birth defects in human congenital defects, first, it brings a heavy burden to family and society, so it is extremely important for prenatal diagnosis. The prenatal diagnosis of congenital heart disease mainly through two ways, namely, ultrasonography and genetic testing. The main method of ultrasonic inspection is accomplished by screening for fetal early or middle-late pregnancy, so as to determine fetal congenital heart disease. During the screening includes：measurement of fetal nuchal translucency （nuchal translucency, NT） thickness, collecting venous duct lfow spectrum, tricuspid regurgitation, cardiac structure and scanning, the application of STIC technology;including middle-late pregnancy screening：the abdominal transverse section view, four chamber view, left and right ventricular outlfow view, three vessels trachea view, great artery short axis view, the inferior vena cava long axis view, long axis view of aortic arch, arterial duct arch long axis view, section scan. Now the prenatal diagnosis of congenital heart disease situation in ultrasound aspects were reviewed, the diagnosis of fetal congenital heart disease were more effective, selection for prenatal eugenics, postpartum neonatal get has very important signiifcance for timely treatment and improving birth quality.