孕中期复杂性先心病的产前超声筛查

Ultrasound Prenatal Screening for Complex Congenital Heart Disease During the Second Trimester

目的探讨孕中期超声对复杂性先天性心脏病的筛查作用,提高复杂性先心病的检出率。方法 2010年10月至2013年10月期间,我院7 295例孕妇于孕21~40周,分别进行对照组（B超检查）和观察组（通过美国GE Voluson 730彩色多普勒超声诊断仪,通过心脏超声筛查的5个标准切面,发现异常心脏节段,再通过彩色多普勒血流信号,观察房室、大动脉血流情况,分析先天性心脏病类型）检查。产前超声诊断结果与本院尸检结果,进行对比分析。结果与对照组相比,观察组复杂性先天性心脏病的临床诊断率明显升高（0.27%vs.0.12%）,差异有统计学意义（P〈0.05）。7 295例胎儿检出20例复杂性先天性心脏病,其中6例合并心外畸形,14例本院引产,其尸检结果与产前超声诊断结果相一致。结论复杂性先天性心脏病的畸形情况多变,超声分段检查结合彩色多普勒超声的产前超声筛查能够有效提高复杂性先心病的检出率。

Objective To explore the effect of ultrasound prenatal screening for complex congenital heart disease during the second trimester, and to improve the detection rate of complex congenital heart disease. Methods From October 2010 to October 2013, 7 295pregnant women（pregnant between 21 ~ 40 weeks） in our hospital received the B-ultrasonic examination（control group） and color Doppler ultrasonography（GE Voluson 730） examination（observation group） respectively. Color Doppler ultrasonography examination found out abnormal heart segments through screening five standard section of cardiac ultrasound, then by color Doppler flow signals, the atrioventricular and aortic blood flow situation were observed, and the types of congenital heart disease were analyzed. Prenatal ultrasound diagnosis results and hospital autopsy results were taken for comparative analysis. Results Compared with the control group, the clinical diagnosis rate of complex congenital heart disease significantly increased in the observation group（0.27% vs. 0.12%）, with statistical difference（P 0.05）. The 20 cases of complex congenital heart disease were detected in the 7 295 fetus cases including 6 cases of cadiac malformation, and 14 cases of induced labor in our hospital, and the autopsy results were consistent with the prenatal ultrasound diagnosis.Conclusions The abnormal situation of complex congenital heart disease is changeable. The prenatal ultrasound screening examination of echocardiography sectional examination combined with color Doppler ultrasound can effectively improve the detection rate of complex congenital heart disease.