超声心动图在高危胎儿产前心脏筛查中的临床价值

Clinical value of echocardiography in prenatal heart screening in high-risk fetuses

目的探讨超声心动图在高危胎儿产前心脏筛查中的临床价值。方法对5 682例(其中1 628为高危胎儿,4 054为非高危胎儿)胎儿行超声心动图检查,探查四腔心、左右室流出道、主动脉弓等切面,观察心脏结构及大血管走行等,应用彩色多普勒血流显像观察各瓣口及血流情况,注意有无异常血流,并测瓣口及主、肺动脉流速。结果检出胎儿先天性心脏结构异常共84例,53例为高危胎儿,31例为非高危胎儿,高危胎儿的检出率明显高于非高危胎儿,两者差异比较有统计学意义(P<0.05)。其中产前检出78例,6例漏诊。结论超声心动图是产前诊断先天性心脏病比较准确和安全的影像学方法,对于高危胎儿,应早期筛查、及时诊断和干预,以减少先天性心脏病患儿的出生及不良预后。

Objective To investigate the clinical value of echocardiography in prenatal heart screening in highrisk fetuses. Methods Prenatal fetal echocardiography screening were performed in 5 682 cases（1 628 cases highrisk fetuses, and 4 054 non-high-risk ones） by four chamber view,outflow tract of left and right ventricular view and aortic arch view methods. Cardiac structure and distribution of large vessels were detected. Valve orifices and blood flow were observed by color Doppler flow imaging. Attention was paid to whether abnormal blood flow appeared. Valve orifices, aortic blood flow velocity and pulmonary artery blood flow velocity were examined. Results Eighty-four cases of cardiac structure abnormality were confirmed by screening, including 53 cases of high-risk fetuses and 31 nonhigh-risk ones.The detection rate in the high-risk fetuses was clearly higher than that in the non-high-risk ones. The comparison between them was statistically meaningful（P0.05）. 78 cases were detected in the prenatal screening. 6 cases were missed. Conclusion Echocardiography is the comparatively exact and secure imaging method in prenatal diagnosis of congenital heart disease. High-risk fetuses are early screened, timely diagnosed and intervened to reduce the birth number of infants with congenital heart disease and poor prognosis.