论文部分内容阅读
目的应用B型和M型超声对胎儿心功能进行评价。方法选择400例在本院接受胎儿产前超声检查的孕妇,应用B型超声检查胎儿心脏的结构,应用M型超声测量胎儿左右心房的收缩期左右内径(LAS、RAS)及舒张末期左右内径(LAD、RAD),计算左右心房的短轴缩短率(LAFS、RAFS),并分析其B/M超声检查结果。测量三尖瓣瓣环平面收缩期位移(TAPSE)以及右心室面积变化率(RVPCA)。结果 B超共检出胎儿心血管异常者8例(2%);正常胎儿心房运动以侧壁运动为主,卵圆瓣和左心房壁为逆向运动,与右心房壁呈同向运动;左、右心房游离壁的运动方式均为心房收缩期的向心运动,心房舒张期的离心运动;随着孕龄的增大,胎儿LAD、LAS和RAD、RAS均呈增大趋势(P<0.05),LAFS在各个孕周内均显著高于RAFS(P<0.05),主要与卵圆瓣的运动方向相关;TAPSE与RVPCA相关性良好(P<0.05)。结论 B型超声能够直观显示胎儿心脏结构,M型超声能够较好评价胎儿心房功能,胎儿期左右心房均有较好的收缩能力。通过测量TAPSE可以评价右心室功能。B型超声和M超声联合应用具有很大的临床应用价值。
Objective To evaluate fetal cardiac function using type B and M ultrasound. Methods 400 pregnant women who underwent prenatal ultrasound examination in our hospital were selected. The structure of fetal heart was examined by B ultrasound. The left and right internal diameters (LAS, RAS) and left and right end diastolic diameter LAD and RAD) were used to calculate the short axis shortening ratio (LAFS, RAFS) of left and right atrium. The results of B / M ultrasonography were analyzed. Tricuspid annulus plane systolic displacement (TAPSE) and right ventricular area change (RVPCA) were measured. Results Eight patients (2%) had abnormal fetus cardiovascular abnormalities detected by B-mode ultrasonography. The normal fetus had lateral movement of the atrium and the oval valve and the left atrial wall were in reverse movement and showed the same direction with the right atrial wall. , Right atrium free wall movement are atrial systolic centripetal movement, atrial diastolic eccentric exercise; with increasing gestational age, fetal LAD, LAS and RAD, RAS showed an increasing trend (P <0.05 ). LAFS was significantly higher than RAFS in each gestational week (P <0.05), mainly related to the motion of the oval valve. The correlation between TAPSE and RVPCA was good (P <0.05). Conclusion B-mode ultrasound can visualize the fetal heart structure. M-mode ultrasound can better evaluate the fetal atrial function, and have a better ability of contracting atrial around the fetus. Right ventricular function can be assessed by measuring TAPSE. B-mode ultrasound combined with M ultrasound has great clinical value.