肺静脉血流流速监测在产前胎儿心脏异常超声筛查中的诊断应用价值

Diagnostic value of pulmonary venous flow velocity monitoring in prenatal ultrasound screening of fetal cardiac abnormalities

目的探究肺静脉血流流速监测在产前胎儿心脏异常超声筛查中的临床价值。方法回顾性分析2020年6月至2022年6月本院收治的42例孕妇的临床资料,按照诊断结果是否正常分为对照组与研究组,每组21例。研究组诊断结果为心脏结构畸形,对照组诊断结果为正常。比较两组肺静脉流速指数、研究组心脏异常情况与肺静脉血流流速的关系,分析研究组彩色多普勒和随访结果。结果两组肺静脉血流S峰、D峰及S/A、S/D值比较差异无统计学意义;研究组A峰,(S-A)/D值均低于对照组,差异有统计学意义(P<0.05);研究组左心室肥厚胎儿(SA)/D值均低于左心室发育不良等8种心脏结构异常类型胎儿,差异有统计学意义(P<0.05)。左心室发育不良、单纯室间隔缺损各漏诊1例,漏诊率为0.13%。左心室肥厚、心内膜垫缺损、三尖瓣重度反流、右心房憩室等检查无误差。结论超声筛查能准确检测出胎儿心脏异常情况,心脏结构异常胎儿其(S-A)/D值差异显著,肺静脉血流流速可作为超声检测的重要指标,值得临床推广应用。

Objective To investigate the clinical value of pulmonary venous blood flow velocity monitoring in prenatal ultrasound screening for fetal cardiac abnormalities.Methods The clinical data of 42 pregnant women admitted to our hospital from June 2020 to June 2022 were retrospectively analyzed,and they were devied into the control group and the study group according to whether the diagnosis results were normal,with 21 cases in each group.The study group diagnosed cardiac structural malformation,and the control group diagnosed normal.The pulmonary venous flow index were compared between the two groups,the relationshipn cardiac abnormality and pulmonary venous blood flow rate in the study group,and the color Doppler and follow-up results of the study group were analyzed.Results There were no significant differences in the S peak,D peak and S/A and S/D values of pulmonary venous blood flow between the two groups.The A peak and(S-A)/D values in the study group were lower than those in the control group,and the difference was statistically significant(P<0.05).The left ventricular hypertrophy fetal(S-A)/D values in the study group were lower than those of 8 types of cardiac structural abnormalities,including left ventricular dysplasia,and the difference was statistically significant(P<0.05).One case of left ventricular dysplasia and one case of simple ventricular septal defect were missed,and the missed diagnosis rate was 0.13%.Left ventricular hypertrophy,endocardial pad defect,severe tricuspid regurgitation,right atrial diverticula and other examinations are error-free.Conclusion Ultrasound screening can accurately detect fetal cardiac abnormalities,and the(S-A)/D values of fetuses with abnormal heart structure are significantly different,and pulmonary venous blood flow rate can be used as an important indicator of ultrasound detection,which is worthy of clinical promotion and application.