儿童先天性心脏病诊断中彩色多普勒超声的应用及其临床价值

The application of color ultrasound in the diagnosis of congenital heart disease in children and its clinical value

目的探讨儿童先天性心脏病(CHD)诊断中彩色多普勒超声的应用及其临床价值。方法选取2015年1月-2018年12月在丽水市妇幼保健院行CHD筛查的儿童13805例。所有患儿均经彩色多普勒超声检查,将所有患儿最终临床诊断和(或)手术结果作为对比金标准。观察所有患儿的最终诊断结果;观察与最终临床诊断结果相比彩色多普勒超声的诊断符合率;观察彩色多普勒超声诊断CHD患儿的临床效果。结果其中,有3138例(22.7%)被最终确诊为CHD。3138例CHD患儿当中,占比最高的畸形为:房间隔缺损2517例(80.2%)和室间隔缺损485例(15.5%)。3138例CHD患儿中,彩色多普勒超声共检查出3046例,总符合率为97.1%。彩色多普勒超声诊断CHD患儿的准确率为99.3%,特异度为100.0%,灵敏度为97.1%。结论给予CHD患儿进行临床诊断的过程当中,使用彩色多普勒超声可以将患儿体内的房间隔、室间隔的生理结构进行更为清晰的显示,为临床诊断提供更多的参考信息,从而提高临床对CHD的诊断效率。

Objective To explore the application and clinical value of color ultrasound in the diagnosis of congenital heart disease in children.Methods A total of 13805 children with congenital heart disease who were screened in our hospital from January 2015 to December 2018 were selected.All children were examined by three-dimensional color ultrasound,and the final clinical diagnosis and/or surgical results of all children were taken as the gold standard for comparison.To observe the final diagnosis of all children;To observe the diagnostic coincidence rate of three-dimensional color ultrasound compared with the final clinical diagnosis result;To observe the clinical efficacy of three-dimensional ultrasound in the diagnosis of congenital heart disease in children.Results 3138 cases(22.7%)were finally diagnosed as congenital heart disease.Among the 3138 children with congenital heart disease,the malformations with the highest proportion were:atrial septal defect(ASD):2517 cases(80.2%)and ventricular septal defect:485 cases(15.5%).Among the 3138 children with congenital heart disease,3046 cases were detected by 3 d ultrasound,with a total coincidence rate of 94.1%.The accuracy,specificity and sensitivity of 3 d ultrasound in the diagnosis of congenital heart disease were 94.1%,87.4%and 86.1%respectively.Conclusion In the process of clinical diagnosis of congenital heart disease in children,the use of color doppler ultrasound can display the physiological structure of atrial septum and ventricular septum in children more clearly,providing more reference information for clinical diagnosis,thus improving the clinical diagnosis efficiency of congenital heart disease.