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目的探讨超声心动图诊断胎儿动脉导管狭窄的价值。方法孕32~38周孕妇常规产科超声检查发现胎儿右心增大伴三尖瓣反流58例,进一步行胎儿超声心动图检查,于动脉导管横断面、三血管气管切面和动脉导管弓切面观察导管形态,测量导管内径及血流频谱。结果超声诊断胎儿动脉导管狭窄6例,均表现右心明显增大,三尖瓣中-重度反流,三尖瓣最大反流速度3.5~4.5m/s,最大压差(maximum transprosthetic pressure gradient,MTPG)49~81mm Hg;胎儿动脉导管呈弯曲或折角现象,管腔细窄,内径1.5~2.5 mm,收缩期峰值血流速度1.8~3.2 m/s,MTPG 13~41mm Hg,舒张期血流速度0.4~2.0m/s,MTPG 0.64~16.00mm Hg;胎儿出生后7d~3个月复查心脏超声,2例三尖瓣反流消失,4例仅有少量反流,心脏大小、形态均恢复正常。结论胎儿超声心动图可显示动脉导管形态和血流异常,较早发现胎儿动脉导管狭窄,评估胎儿风险,对提高围产儿安全有重要价值。
Objective To investigate the value of echocardiography in diagnosing fetal arterial stenosis. Methods The routine obstetric ultrasound examination of pregnant women aged 32-38 weeks found that the right heart increased with tricuspid regurgitation in 58 cases. The fetus was further examined by echocardiography. The catheter was observed on the arterial catheter cross-section, tri-vascular tracheal section and arterial catheter arch section Morphology, measurement of catheter diameter and blood flow spectrum. Results Ultrasound diagnosis of fetal artery catheter stenosis in 6 cases, all showed a significant increase in right heart, tricuspid regurgitation, tricuspid regurgitation velocity of 3.5 ~ 4.5m / s, maximum pressure drop (maximum transprosthetic pressure gradient, MTPG) ranged from 49 to 81 mm Hg. Fetal ductula were curved or angled with a narrow lumen with an internal diameter of 1.5 to 2.5 mm. The peak systolic velocity was 1.8 to 3.2 m / s, MTPG 13 to 41 mm Hg, diastolic blood flow Heart rate was 0.4 ~ 2.0m / s, and MTPG was 0.64 ~ 16.00mm Hg. Cardiac echocardiography was rechecked 7 days to 3 months after birth. Tricuspid regurgitation disappeared in 2 cases. Only a small amount of reflux occurred in 4 cases. normal. Conclusion Fetal echocardiography can show the ductal morphology and abnormal blood flow. Earlier detection of fetal ductal stricture to assess fetal risk was of great value in improving perinatal safety.