超声对不同分型单纯室间隔缺损胎儿的诊断及新生儿闭合期的研究

Study on ultrasound diagnosis of different types of fetus with simple ventricular septal defect and neonatal closure period

目的 探讨超声对不同分型单纯室间隔缺损胎儿的诊断及新生儿闭合期随访结果分析。方法 选取2019年1月至2021年12月于中国人民解放军联勤保障部队第九〇三医院确诊的单纯室间隔缺损胎儿100例,均进行超声心动图检测,观察病理分型及缺损直径。随访1年后观察患儿的愈合率。结果 100例胎儿中膜部缺损型64例、漏斗部缺损型21例、肌部缺损型11例、室上嵴上方缺损型4例。膜部缺损型中缺损口直径>5mm占比较高(46.88%),其次是3~5mm(34.38%)及<3mm(18.75%);漏斗部缺损型中缺损口直径<3mm占比较高(66.67%),其次是3~5mm(33.33%);肌部缺损型中缺损口直径<3mm及3~5mm占比分别为45.45%及54.55%;室上嵴上方缺损型中缺损口直径<3mm及3~5mm占比相同,均为50.00%;肌部缺损型患儿宫内及出生后1年内的愈合率最高(72.73%),其次为膜部缺损型(26.56%),漏斗部缺损型及室上嵴上方缺损型患儿在宫内及出生后1年内均未愈合。结论 单纯室间隔缺损以膜部缺损型常见,膜部及肌部缺损型可自然愈合。超声心动图在单纯室间隔缺损胎儿的产前诊断及出生后随访中作为一种可靠的检查手段,可为日后治疗提供可靠依据。

Objective To investigate the diagnosis of different types of fetuses with simple ventricular septal defect by ultrasound and to analyze the results of neonatal follow-up during the closed period.Methods A total of 100 fetuses diagnosed with simple ventricular septal defect from January 2019 to December 2021 were selected from the 903rd Hospital of the Joint Logistics Support Force of the People’s Liberation Army of China,and echocardiography was performed to observe the type and defect diameter.The healing rate of the children was observed after 1 year follow-up.Results In 100 cases,64 cases were medial defect,21 cases were infundibular defect,11 cases were muscular defect and 4 cases were superior ventricular ridge defect.In the membrane defect type,the proportion of defect diameters>5mm was highest at 46.88%,followed by 3-5mm at 34.38%,and<3mm at 18.75%.In the infundibular defect type,the defect diameter<3mm was higher(66.67%),followed by 3-5mm(33.33%).The probability of<3mm defect mouth diameter and 3-5mm defect mouth diameter were 45.45%and 54.55%,respectively.The diameter of the defect<3mm and 3-5mm were the same,both of which were 50.00%.The healing rate of intrauterine and 1 year after birth was the highest in muscular defect type(72.73%),followed by membrane defect type(26.56%),infundibular defect type and superior ventricular crest defect type did not heal in intrauterine and 1 year after birth.Conclusion Simple ventricular septal defect is common in the membranous part,while the membranous part and muscle part defect can heal naturally.Echocardiography is a reliable examination method in the prenatal diagnosis and postnatal follow-up of the fetus with simple ventricular septal defect,which can provide a reliable basis for future treatment.