80例胎儿单纯室间隔缺损预后分析

Prognosis analysis of 80 cases of simple fetal ventricular septal defect

目的探讨胎儿超声心动图定量分析诊断胎儿单纯室间隔缺损的价值及意义。方法选取2019年1月至2021年12月于内蒙古自治区妇幼保健院行胎儿系统性超声筛查并在本院生产的34513名孕妇作为研究对象,采用超声心动图复查出生后5 d内、6个月新生儿单纯室间隔缺损情况。分析胎儿时期不同部位室间隔缺损自愈情况,比较不同部位室间隔缺损出生5 d内、出生6个月患儿自愈率;分析不同时间胎儿超声心动图诊断胎儿单纯性室间隔缺损的漏诊情况;比较室间隔缺损过隔血流信号内径≤0.2 cm与间隔缺损过隔血流信号内径>0.2 cm出生5 d内自愈情况;比较室间隔缺损内径≤0.4 cm与室间隔缺损内径>0.4 cm患儿出生6个月室间隔缺损自愈情况。结果34513例孕妇中,诊断胎儿单纯室间隔缺损80例,出生后5 d符合室间隔缺损诊断39例,诊断符合率为48.750%;6个月后复查,自愈7例,自愈率为17.949%,32例需行手术干预;出生5 d内新生儿肌部室间隔缺损自愈率高于膜周部室间隔缺损自愈率(P<0.05);出生后6个月肌部室间隔缺损自愈率与膜周室间隔缺损自愈率比较差异无统计学意义。2019至2021年漏诊率分别为0.100%、0.078%、0.055%。室间隔缺损过隔血流信号内径≤0.2 cm患儿出生5 d内室间隔缺损自愈率高于过隔血流信号内径>0.2 cm患儿,差异有统计学意义(P<0.05)。室间隔缺损内径≤0.4 cm患儿出生6个月室间隔缺损自愈率高于与室间隔缺损内径>0.4 cm患儿,差异有统计学意义(P<0.05)。结论胎儿超声心动图定量分析对评估胎儿单纯室间隔缺损的预后具有重要意义。

Objective To investigate the value and significance of fetal echocardiography in the diagnosis of simple fetal ventricular septal defect.Methods A total of 34513 pregnant women who underwent fetal systematic ultrasound screening and delivered in Maternal and Child Health Hospital of Inner Mongolia Autonomous Region from January 2019 to December 2021 were selected as the research subjects.The cases of simple ventricular septal defect within 5 d and 6 months after birth were examined by echocardiography.The self-healing of ventricular septal defect in different parts of the fetus was analyzed;the self-healing rate of ventricular septal defect in different parts within 5 d after birth and 6 months after birth was compared;the missed diagnosis of simple fetal ventricular septal defect by fetal echocardiography at different time was analyzed;the self-healing within 5 d after birth was compared between ventricular septal defect with diameter≤0.2 cm and ventricular septal defect with diameter>0.2 cm was compared;the self-healing of fetal ventricular septal defect at 6 months after birth in children with ventricular septal defect diameter≤0.4 cm and ventricular septal defect diameter>0.4 cm was compared.Results Among the 34513 pregnant women,80 cases were diagnosed with pure ventricular septal defect,and 39 cases were confirmed 5 d after birth,the diagnosis coincidence rate was 48.750%;after 6 months of reexamination,7 cases were self-healed,the self-healing rate was 17.949%,and 32 cases needed surgical intervention.The self-healing rate of muscular ventricular septal defect was higher than that of perimembranous ventricular septal defect within 5 d after birth(P<0.05);there was no significant difference in the self-healing rate of muscular ventricular septal defect and perimembranous ventricular septal defect at 6 months after birth.The missed diagnosis rates from 2019 to 2021 were 0.100%,0.078%and 0.055%,respectively.The self-healing rate of ventricular septal defect at 5 d after birth in children with septal flow signal diameter≤0.2 cm was higher than that in children with septal flow signal diameter>0.2 cm,and the difference was statistically significant(P<0.05).The self-healing rate of ventricular septal defect in children with ventricular septal defect diameter≤0.4 cm was higher than that in children with ventricular septal defect diameter>0.4 cm at 6 months after birth,and the difference was statistically significant(P<0.05).Conclusion Quantitative analysis of fetal echocardiography is of great significance in evaluating the prognosis of fetal ventricular septal defect.