产前超声心动图检查胎儿先天性心脏病的临床价值

Clinical value of prenatal echocardiography in diagnosis of fetal congenital heart diseases

目的：探讨产前超声心动图对于胎儿先天性心脏病的诊断价值。方法：回顾性分析该院2011年1月~2013年1月进行胎儿超声心动图检查,不具有高危倾向的孕妇276例,具有高危倾向的孕妇178例,采取主动脉弓切面、胎儿四腔心切面、动脉导管弓切面、左右室流出道切面、上下腔静脉长轴切面及三血管切面,观察心脏大小、结构和大血管的走行、位置等;同时应用彩色多普勒血流显像观察大血管内血流情况、各瓣口及间隔情况。结果：产前超声心动图诊断发现胎儿先天性心脏病18例,完全性心内膜垫缺损2例,右室双出口1例,左心发育不良1例,法乐四联征3例,三尖瓣闭锁2例,单纯室间隔缺损6例,主动脉瓣狭窄1例。漏诊Ⅱ型房间隔缺损2例。产前诊断胎儿先天性心脏病的灵敏度为90%,特异度为100%,P〈0.01。结论：产前超声心动图具有较高的灵敏度和特异度,可在无创的情况下有效对胎儿先天性心脏病做出产前诊断,令胎儿在出生前得以及时诊治。

Objective： To explore the diagnostic value of prenatal echocardiography for fetal congenital heart diseases. Methods： A total of 276 pregnant women without high risk tendency and 178 pregnant women with high risk tendency receiving fetal echocardiography in the hospital from January 2011 to January 2013 were analyzed retrospectively; aortic arch view, fetal four- chamber view, arterial duct bow view, left and right ventricular outflow tract view, superior and inferior vena cava long axis view and three - vessel view were adopted to observe cardiac size, structure and running position of great vessels ; meanwhile, color Doppler blood flow imaging was used to observe blood flow of great vessels, valve orifice and spacing conditions. Results： Eighteen patients with fetal congenital heart diseases, two patients withcomplete endocardial cushion defect, one patient with double outlet right ventricle, one patient with hypoplastic left heart, three patients with tetralogy of Fallot, two patients with tricuspid atresia, six patients with simple ventricular septal defect and one patient with aortic stenosis were diagnosed by prenatal echocardiography. Two patients with type Ⅱatrial septal defect were missed diagnosed. The sensitivity and specificity of prenatal echocardiography in diagnosis of fetal congenital heart diseases were 90% and 100% , respectively （ P 〈 0. 01 ） . Conclusion： Prenatal echocardiography has high sensitivity and specificity, which can diagnose fetal congenital heart diseases before delivery without invasion, so the fetuses with congenital heart diseases can be diagnosed and treated timely before birth.