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目的:探讨心脏超声筛查对胎儿先天性心脏病诊断及临床应用价值。方法:应用Philips IU22彩色多普勒超声诊断仪对于医院妇产科就诊的3968例孕妇进行产前超声系统筛查,对胎儿心脏的四腔心切面,左、右室流出道切面,主动脉弓切面,动脉导管弓切面进行仔细扫描,观察胎儿心脏结构形态及功能状态。结果:72例确诊的先天性心脏病胎儿中,室间隔缺损14例、房间隔缺损7例、法洛四联症9例,左心、右心发育不良分别为3例、4例,永存左上腔静脉、永存动脉干分别为4例、2例,右室双出口、主动脉弓离断各3例,心内膜垫缺损5例,单心腔、心内膜垫缺损各6例,三尖瓣下移畸形4例,左室横纹肌瘤2例。漏诊房间隔缺损1例,三尖瓣下移畸形2例,漏诊率4.2%。结论:胎儿心脏超声检查可以提前检出先天性心脏病,避免严重先心病胎儿的出生、提高优生优育水平具有重要的临床和现实意义。
Objective: To investigate the diagnostic value of echocardiography for fetal congenital heart disease and its clinical value. Methods: 3968 pregnant women in the obstetrics and gynecology department of the hospital were examined by Philips IU22 color Doppler ultrasound system. The four-chamber heart section, left and right ventricular outflow tract sections, aortic arch section, Artery catheter arch section carefully scanned to observe fetal cardiac structure and functional status. Results: 72 cases of congenital heart disease were diagnosed as ventricular septal defect in 14 cases, atrial septal defect in 7 cases, tetralogy of Fallot in 9 cases, left ventricular and right ventricular dysplasia were 3 cases, 4 cases, Vena cava and perpetual arterial trunk were 4 cases, 2 cases, right ventricular double outlet, 3 cases of aortic arch disconnection, 5 cases of endocardial cushion defect, 6 cases of single heart cavity and endocardial cushion defect, 3 cases of tricuspid valve Down 4 cases of deformity, left ventricular rhabdomyoma in 2 cases. Misdiagnosis of atrial septal defect in 1 case, tricuspid regurgitation in 2 cases, missed diagnosis rate of 4.2%. Conclusion: Fetal heart ultrasound can detect congenital heart disease in advance, avoid the birth of fetus with severe congenital heart disease and improve the level of prenatal and postnatal care. It has important clinical and practical significance.