胎儿心脏超声筛查用于先天性心脏病检测的临床价值分析

Clinical Value Analysis of Fetal Heart Ultrasound Screening for Congenital Heart Disease

目的探讨并分析先天性心脏病检测中应用胎儿心脏超声筛查方式对诊断疾病的价值,为临床干预及治疗提供可靠参考。方法选取2020年4月-2022年3月收治的新生儿先天性心脏病高风险孕妇140例为研究对象。针对所有的孕妇均是接受二维超声检查、胎儿心脏超声筛查,以最终引产或者生产结局作为“金标准”,观察最终确定先天性心脏病的检出情况,此外比较不同的方式检查对先天性心脏病的诊断效能。结果“金标准”的方式,最终确诊60例(42.86%)孕妇胎儿为先天性心脏病,其中8例(13.33%)为心内膜垫缺损,10例(16.67%)为法洛四联症伴唇腭裂,13例(21.67%)为室间隔缺损,9例(15.00%)为单心室,8例(13.33%)为三尖瓣下移,8例(13.33%)为三房心,4例(6.67%)为肺动脉瓣狭窄伴右室发育不良。在对先天性心脏病的诊断敏感度、准确度、阴性预测值方面,胎儿心脏超声筛查方式分别为96.67%、97.86%、97.53%,常规二维超声检查方式分别为83.33%、92.14%、88.76%,胎儿心脏超声筛查的诊断敏感度、准确度、阴性预测值均明显高于常规二维超声检查(P<0.05)。结论针对先天性心脏病检测,采取胎儿心脏超声筛查方式的检出率较高,诊断效能突出,值得推广。

Objective To explore and analyze the diagnostic value of fetal heart ultrasound screening in the detection of congenital heart disease,and to provide reliable reference for clinical intervention and treatment.Methods 140 pregnant women at high risk of congenital heart disease were selected from April 2020 to March 2022 as subjects.All pregnant women received two-dimensional ultrasound examination and fetal heart ultrasound screening,and the final labor induction or birth outcome was taken as the gold standard to observe and determine the final detection of congenital heart disease.In addition,the diagnostic efficacy of different methods of examination for congenital heart disease was compared.Results According to the gold standard method,60 cases(42.86%)of pregnant women were diagnosed with congenital heart disease,including 8 cases(13.33%)of endocardial pad defect,10 cases(16.67%)of tetralia fallot with cleft lip and palate,13 cases(21.67%)of ventricular septal defect,and 9 cases(15.00%)of single ventricle.Eight cases(13.33%)had tricuspid valve descending,eight cases(13.33%)had tricatrial heart,and four cases(6.67%)had pulmonary stenosis with right ventricular dysplasia.In terms of diagnostic sensitivity,accuracy and negative predictive value of congenital heart disease,fetal heart ultrasound screening methods were 96.67%,97.86%and 97.53%,and routine two-dimensional ultrasound methods were 83.33%,92.14%and 88.76%.The diagnostic sensitivity,accuracy and negative predictive value of fetal heart ultrasound screening were significantly higher than those of conventional two-dimensional ultrasound(P<0.05).Conclusion For the detection of congenital heart disease,the fetal heart ultrasound screening method has a high detection rate and outstanding diagnostic efficiency,which is worth popularizing.