超声四腔心头侧偏转法联合顺序节段分析法在胎儿先天性心脏病筛查中的价值

Clinical value of ultrasound four-chamber view cephalic deviation method combined with sequential segmental analysis method in screening of fetal congenital heart diseases

目的探讨应用超声四腔心头侧偏转法联合顺序节段分析法在诊断胎儿先天性心脏病中的价值。方法对2014年2月-2016年8月在唐山市妇幼保健院就诊的3266例孕妇进行胎儿先天性心脏病筛查,分别用四腔心头侧偏转法和超声四腔心头侧偏转法联合顺序节段分析法对胎儿心脏进行筛查并诊断。诊断后对所有患者进行跟踪随访,产后进行超声心动图检查或尸体解剖进行分析与证实。结果产后超声及尸检结果显示有先天性心脏病患儿31例,漏诊误诊3例;四腔心头侧偏转法联合顺序节段分析法诊断先天性心脏病敏感性90.32%,漏诊率为9.68%,与单独用四腔心头侧偏转法相比较差异均有统计学意义(P<0.05)。结论用超声四腔心头侧偏转法联合顺序节段分析法进行胎儿先天性心脏病筛查准确率高、敏感性强,具有较好的应用价值。

Objective To explore the clinical value of ultrasound four-chamber view cephalic deviation method combined with sequential segmental analysis method in diagnosis of fetal congenital heart diseases. Methods Fetal congenital heart diseases screening was carried out among 3 266 pregnant women in the hospital from February 2014 to August 2016. These cases were screened and diagnosed by ultrasound four-chamber view cephalic deviation method and ultrasound four-chamber view cephalic deviation method combined with sequential segment analysis method,respectively. All the patients were followed up after diagnosis,and the results were analyzed and confirmed by postpartum echocardiography and autopsy results. Results The result of postpartum echocardiography and autopsy showed that there were 31 cases with fetal congenital heart diseases and 3 misdiagnosed patients. The diagnostic sensitivity of four-chamber view cephalic deviation method combined with sequential segmental analysis method for congenital heart diseases was 90. 32%,the rate of missed diagnosis was 9. 68%. There was statistically significant difference compared with ultrasound four-chamber view cephalic deviation method（ P〈0. 05）. Conclusion Ultrasound four-chamber view cephalic deviation method combined with sequential segment analysis for screening fetal congenital heart diseases has high accuracy,sensitivity and good application value.