孕11～14周胎儿超声软指标在胎儿心脏结构评估中的价值

The Value of Fetal Ultrasonography in Fetal Heart Structure Evaluation of 11 to 14 Weeks

目的:对孕11~14周胎儿超声软指标在胎儿心脏结构评估中的价值予以探讨。方法:随机选取笔者所在医院2016年1月-2017年1月开展超声检查的孕11~14周胎儿2 000例,对其检查结果及妊娠结局进行观察记录,分析超声软指标在早孕期胎儿先天性心脏病中的诊断情况。结果:所选2 000例胎儿中,通过开展产前超声诊断,发现15例严重先天性心脏病,检出率为0.45%,这其中有6例存在染色体异常现象,其中有4例合并有三尖瓣反流(TR),有3例合并静脉导管血流a波(DVa)倒置,胎儿颈后透明层厚度(NT厚度)值大于第99百分位的18例胎儿中有5例诊断为先天性心脏病;NT厚度值小于第95百分位的1 879例胎儿中,有8例诊断为先天性心脏病;NT厚度值处于95~99百分位的103例胎儿中有2例诊断为先天性心脏。结论:为孕11~14周胎儿开展超声检查,DVa倒置、TR、NT增厚等软指标在其心脏结构评估当中具有非常重要的临床价值,值得在早孕检查中推广。

Objective：To discuss the value of fetal ultrasonography in the evaluation of fetal heart structure in 11-14 weeks of gestation.Method：From January 2016 to January 2017,2 000 cases who carried out ultrasound in the 11 to 14 weeks of pregnancy to fetuses were randomly selected,the results of the examination and pregnancy outcome were observed records,and then the ultrasound index in early pregnancy fetal heart structure in the false positive rate of the calculation,as the basis for judging the analysis of ultrasound soft indicators in early pregnancy fetal congenital heart disease in the diagnosis.Result：Among the 2 000 fetuses,15 cases of severe congenital heart disease were detected by prenatal ultrasound.The detection rate was 0.45%.There were 6 cases of chromosomal abnormalities.Among them,4 cases had tricuspid valve TR,3 patients with juvenile heart disease were diagnosed fetal caliper（DVa） inverted,5 patients of 18 cases were diagnosed juvenile heart disease by fetal neck transparent layer thickness（NT thickness） greater than the 99 th percentile.The thickness of less than the 95 th percentile of the 1 879 cases of the fetus,8 cases diagnosed with congenital heart disease,NT thickness of 95 to 99 percentile of 103 cases of fetal in 2 cases diagnosed with congenital heart disease.Conclusion：For the 11 to 14 weeks of pregnancy to carry out ultrasound,DVa inversion,TR,NT thickening and other soft indicators in the evaluation of its heart structure which has a very important clinical and value,it is worth to promote in early pregnancy examination.