超声心脏五腔心切面在胎儿先心病筛查中的应用价值

Application Value of Ultrasonic Heart Five Chamber View in the Screening of Fetal Congenital Heart

目的研究超声心脏五腔心切面在胎儿先心病筛查中的应用价值。方法研究对象为2013年2月—2015年2月于该院行产前超声检查的孕妇4 690例（双胎妊娠4例）,采用超声心脏五腔心切面进行先心病筛查,比较不同孕期五腔心切面的获取率及超声诊断灵敏度、特异度。结果孕20-27周时超声检查心脏五切面获取率与孕28-32周及孕32周以后比较显著偏高,差异有统计学意义（P〈0.05）;超声五切面对左、右心系统及心脏肿瘤筛查准确率为100.0%,对间隔发育异常检出率为97.1%（误诊4例,漏诊5例）,对大血管及锥干畸形检出率为100.0%（排除失访1例）;排除失访者超声心脏五腔心切面对先心病诊断的灵敏度为92.9%,特性度为99.9%。结论超声心脏五腔心切面应用于胎儿先心病筛查灵敏度及特异度高,操作方便,临床应用价值高,值得推广。

Objective To study the application value of ultrasonic heart five chamber view in the screening of fetal congenital heart. Methods 4 690 cases of pregnant women（twin pregnancy in 4 cases） receiving prenatal ultrasound examination from February 2013 to February 2015 were selected as the research object and were given congenital heart disease screening by ultrasonic heart five chamber view, the acquisition rate of five chamber view and ultrasonic diagnostic sensitivity and specificity in different pregnant stages were compared. Results the acquisition rate of five chamber view by ultrasonic heart examination in 20-27 week of pregnancy was obviously higher than that in 28-32 week of pregnancy and 32 weeks after pregnancy, the difference was statistically significant（P〈0.05）; by ultrasonic heart five chamber view, the screening accuracy rate of left and right heart system and cardiac tumor was 100.0%, the abnormal detection rate of interval development was 97.1%（ misdiagnosis in 4 cases, missed diagnosis in 5 cases）, the detection rate of large blood vessels and cones was100.0%（lost follow-up in 1 case）,the sensitivity and specificity of congenital heart disease diagnosed by ultrasonic heart five chamber view in the lost follow-up case were respectively 92.9% and 99.9%. Conclusion Ultrasonic heart five chamber view in the screening of fetal congenital heart has high sensitivity and specificity, it is easy to operate and is of high clinical application value, and it is worth promoting.