胎儿血管环超声心动图特征及对预后评估的价值研究

Characteristics of fetal vascular ring echocardiography and its prognostic value

目的分析胎儿血管环超声心动图的特征及对预后评估的价值。方法选取2019年5月—2020年5月在上饶市妇幼保健院行胎儿心脏筛查及超声心动图检查中明确诊断先天性血管环者及一切正常者各40例,分为血管环组和正常组。选择彩色多普勒超声诊断仪对胎儿实施心脏畸形检查,并对血流特征进行观察,总结对超声心动图特征。结果全部40例血管环组胎儿中,右位主动脉弓、左位动脉导管的胎儿人数最多,共22例;其次则为左位主动脉弓、右锁骨下动脉迷走和双主动脉弓胎儿,分别为10例、7例;肺动脉吊带的胎儿人数最少,仅1例。左位主动脉弓、右锁骨下动脉迷走胎儿的气管前后径(D前后)、左右径(D左右)、面积(S)、周长(C)与正常胎儿比较差异无统计学意义(P>0.05);其超声心动图特征主要为气管呈类圆形,形态规则,气管周围存在间隙。右位主动脉弓、左位动脉导管胎儿的超声心动图特征表现为气管为类圆形或椭圆形改变,形态规则;D前后、D左右、S、C等明显小于正常组(P<0.05)。双主动脉弓胎儿的超声心动图特征表现为气管呈不规则形态,气管壁结构模糊,与周围组织的界限模糊,间隙变小;D前后、D左右、S、C等明显小于正常组(P<0.05)。对胎儿结局的跟踪随访结果显示,胎儿结局或预后与超声心动图检查诊断及评估基本一致。结论根据超声心动图特征,不仅能准确诊断和分型先天性血管环疾病,而且还能准确评估预后,具有临床推广价值。

Objective To analyze the characteristics of fetal vascular ring echocardiography and its prognostic value.Methods from May 2019 to may 2020,40 cases of congenital vascular ring and 40 cases of normal were selected and divided into vascular ring group and normal group.The color Doppler ultrasound diagnostic instrument was selected to check the fetal heart malformation,and the blood flow characteristics were observed,and the characteristics of echocardiography were summarized and analyzed.Results In all 40 cases of vascular ring group,the number of fetuses with right aortic arch and left ductus arteriosus was the most,22 cases in total;the next were left aortic arch,right subclavian artery vagal and double aortic arch fetuses,10 cases and 7 cases respectively;the number of fetuses with pulmonary artery sling was the least,only 1 case.There was no significant difference in the anteroposterior diameter(d),left and right diameter(d),area(s),perimeter(c)of the trachea between the fetus with left aortic arch and right subclavian artery aberrations and the normal fetus(P>0.05);the main echocardiographic characteristics of the trachea were round like,regular shape and space around the trachea.The echocardiographic characteristics of the fetus with right aortic arch and left ductus arteriosus showed that the trachea showed round or oval changes with regular shape;the trachea related data before and after D,around D,s and C were significantly less than those in the normal group(P<0.05).The echocardiographic characteristics of the fetus with double aortic arch showed that the trachea was irregular,the trachea wall structure was fuzzy,the boundary with the surrounding tissue was fuzzy,and the gap became smaller;the trachea related data before and after D,around D,s,C were significantly less than those in the normal group(P<0.05);the follow-up results of the fetal outcomes showed that the diagnosis and evaluation of fetal outcomes or prognosis by echocardiography were basically the same Cause.Conclusion According to the characteristics of echocardiography,it can not only accurately diagnose and classify congenital vascular ring disease,but also accurately evaluate the prognosis,which has the value of clinical promotion.