65例胎儿先天性心脏病超声检查分析

Ultrasound Examination Analysis on 65 Cases of Congenital Heart Disease for Fetus

目的：探讨超声检查在胎儿不同时期心脏检查的应用价值。方法：2010年-2014年在肇庆市第二人民医院应用GE730彩超仪对15650例孕妇行常规中孕筛查（20-24）周,高危妊娠胎儿超声心动图检查（24-30周）,晚孕超声检查（30-35周）,部分病例运用STIC技术留取容积数据。结果：超声发现先天性心脏畸形65例中,首次由中孕胎儿筛查发现先心病48例（占73.85%）,误诊5例,漏诊14例。首次由晚孕胎儿筛查发现先心病7例（占10.77%）,误诊1例,漏诊1例。首次由胎儿超声心动图发现先心病8例（占12.31%）,误诊2例,漏诊2例。首次由STIC技术发现先心病2例（占3.07%）。发现的先心病有单纯室间隔缺损22例,完全性心内膜垫缺损9例,不完全性心内膜垫缺损2例、法洛氏四联征6例、大动脉转位4例、右室双出口3例、二尖瓣闭锁左室发育不良2例、三尖瓣下移畸形2例、肺静脉异位引流2例、单心房3例、单心室1例、右位主动脉弓2例、升主动脉狭窄2例、主肺动脉干狭窄2例、肺动脉瓣狭窄1例、永存动脉干1例、房间隔膨出瘤1例。全部经上级医院产前诊断或尸检及产后追踪证实。结论：超声检查胎儿心脏在不同阶段的应用,能优势互补,最大限度减少胎儿先天性心脏病的误诊及漏诊。

Objective To investigate the value of ultrasonography in the cardiac examination during different fetal stages. Methods Applied GE730 ultrasound instrument to screening（20 - 24） weeks on 15650 pregnant women in convention mid-pregnancy screening, the high-risk pregnancy fetal ultrasound echocardiography（24 - 30 weeks） and late pregnancy ultrasound examination（30 - 35 weeks） during 2010- 2014 in Zhaoqing City, the second people＇s Hospital. In some cases using the STIC technology in specimens from volume data. Results In 65 cases of congenital cardiac malformations, 48 cases（73.85 %） were first diagnosed by middle pregnancy, 5 cases were misdiagnosed and 14 cases missed diagnosis. 7 cases（10.77 %） were first diagnosed by fetal screening for the first time, and 1 cases were misdiagnosed and 1 cases missed diagnosis. 8 cases（12.31%） were diagnosed first by fetal echocardiography, and 2 cases were misdiagnosed, and 2 cases missed diagnosis.. First STIC technology found in 2 cases（3.07 %）. Discovery of congenital heart disease with ventricular septal defect（VSD） in 22 cases, 9 cases with complete endocardial cushion defect, incomplete endocardial cushion defect in 2 cases, tetralogy of Fallot syndrome in 6 cases, 4 cases of transposition of the great arteries, right ventricular 3 cases of double outlet, mitral atresia left ventricular developed adverse（2 cases）, Ebstein deformity in 2 cases, pulmonary venous drainage in 2 cases, single atrium in 3 cases, 1 cases of single ventricle, 2 cases of right aortic arch, ascending aorta stenosis（2 cases）, main pulmonary artery trunk stenosis in 2 cases, pulmonary valve stenosis in 1 case, persistent truncus arteriosus stem 1 cases, atrial septal aneurysm in 1 case. All the superior hospital prenatal diagnosis or autopsy and postpartum followup confirmed. Conclusion The ultrasound examination of fetal heart in different stages of the application, can complement each other, to minimize the fetal congenital heart disease misdiagnosed and missed diagnosis.