多普勒超声对孕中期胎儿复杂先天性心脏畸形的筛查价值

Screening value of Doppler ultrasound for complex congenital heart malformations in the second trimester of fetus

目的探讨多普勒超声对孕中期胎儿复杂先天性心脏畸形的筛查价值。方法选取2020年1月至2021年12月厦门大学附属中山医院收治的2338名孕中期产妇作为研究对象。对所有观察对象进行彩色多普勒超声筛查,对产妇进行跟踪随访,产后评估新生儿心脏情况,以产后随访结果为“金标准”,判断彩色多普勒超声的诊断效能,记录超声诊断与产后随访中疾病的分型情况。将超声筛查中复杂先天性心脏畸形胎儿作为观察组,并选取50名正常妊娠胎儿作为对照组,比较两组新生儿的心功能指标。结果彩色多普勒超声诊断复杂先天性心脏畸形的灵敏度为99.77%(428/429),特异度为96.55%(1845/1909),准确度为97.22%(2273/2338)。产后随访中确诊20例复杂先天心脏畸形病例的具体分型,在超声诊断中共检出19例复杂先天心脏畸形分型,符合率95.00%。观察组右心室舒张末期容积(EDV)、收缩末期容积(ESV)以及射血分数(EF)高于对照组,每搏输出量(SV)低于对照组,差异有统计学意义(P<0.05)。结论多普勒彩色超声技术对于孕中期胎儿复杂先天心脏畸形的临床检出率较高,诊断效能明显,并且能够对心功能指标进行观察和分析,可参考实施。

Objective To investigate the value of Doppler ultrasound in screening fetal complex congenital heart malformations in the second trimester of pregnancy.Methods A total of 2338 second-trimester parturients admitted to Zhongshan Hospital Affiliated to Xiamen University from January 2020 to December 2021 were selected as subjects.Color Doppler ultrasound screening was performed on all the observed subjects,and maternal follow-up was conducted.Neonatal heart conditions were evaluated after delivery.The results of postpartum follow-up were regarded as the"gold standard"to judge the diagnostic efficacy of color Doppler ultrasound,and the disease classification during ultrasound diagnosis and postpartum follow-up was recorded.The fetuses with complex congenital heart malformation in ultrasound screening were selected as the observation group,and 50 fetuses with normal pregnancy were selected as the control group,and the cardiac function indexes of neonates in the two groups were compared.Results The sensitivity,specificity and accuracy of color Doppler ultrasonography in diagnosing complex congenital heart malformation were 99.77%(428/429),96.55%(1845/1909)and 97.22%(2273/2338).The specific types of 20 cases of complex congenital heart malformations were confirmed during postpartum follow-up,and a total of 19 cases of complex congenital heart malformations were detected by ultrasound diagnosis,with a coincidence rate of 95.00%.The right ventricular end-diastolic volume(EDV),end-systolic volume(ESV)and ejection fraction(EF)of the observation group were higher than those of the control group,while the output per wave(SV)of the observation group was lower than that of the control group,the difference was statistically significant(P<0.05).Conclusion Doppler color ultrasound has a high clinical detection rate for fetal complex congenital heart malformations in the second trimester of pregnancy,and has obvious diagnostic efficacy.It can also observe and analyze cardiac function indicators,which can be referred to for implementation.