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目的:探讨超声检查在胎儿不同时期心脏检查的应用价值。方法:2010年-2014年在肇庆市第二人民医院应用GE730彩超仪对15650例孕妇行常规中孕筛查(20~24)周,高危妊娠胎儿超声心动图检查(24~30周),晚孕超声检查(30~35周),部分病例运用STIC技术留取容积数据。结果:超声发现先天性心脏畸形65例中,首次由中孕胎儿筛查发现先心病48例(占73.85%),误诊5例,漏诊14例。首次由晚孕胎儿筛查发现先心病7例(占10.77%),误诊1例,漏诊1例。首次由胎儿超声心动图发现先心病8例(占12.31%),误诊2例,漏诊2例。首次由STIC技术发现先心病2例(占3.07%)。发现的先心病有单纯室间隔缺损22例,完全性心内膜垫缺损9例,不完全性心内膜垫缺损2例、法洛氏四联征6例、大动脉转位4例、右室双出口3例、二尖瓣闭锁左室发育不良2例、三尖瓣下移畸形2例、肺静脉异位引流2例、单心房3例、单心室1例、右位主动脉弓2例、升主动脉狭窄2例、主肺动脉干狭窄2例、肺动脉瓣狭窄1例、永存动脉干1例、房间隔膨出瘤1例。全部经上级医院产前诊断或尸检及产后追踪证实。结论:超声检查胎儿心脏在不同阶段的应用,能优势互补,最大限度减少胎儿先天性心脏病的误诊及漏诊。
Objective: To investigate the value of ultrasonography in cardiac examination at different stages of fetus. Methods: From 2010 to 2014, we used GE730 Color Doppler Ultrasound Apparatus in the Second People’s Hospital of Zhaoqing City to screen 15 565 pregnant women for routine gestational screening (20-24 weeks), fetal echocardiography at high risk (24-30 weeks), late Pregnancy ultrasound (30 to 35 weeks), in some cases using STIC technology to take volume data. Results: Among the 65 cases of congenital heart abnormalities detected by ultrasound, 48 cases of congenital heart disease (73.85%), 5 cases of misdiagnosis and 14 cases of missed diagnosis were found by the screening of second trimester fetuses. The first fetal screening by late pregnancy found that seven cases of congenital heart disease (10.77%), misdiagnosis in 1 case, missed diagnosis in 1 case. For the first time, 8 cases of congenital heart disease (12.31%) were found by fetal echocardiography, 2 cases were misdiagnosed and 2 cases were missed. For the first time by the STIC technology found in 2 cases (3.07%). Found congenital heart disease with simple ventricular septum defect in 22 cases, complete endocardial cushion defect in 9 cases, incomplete endocardial cushion defect in 2 cases, tetralogy of Fallot in 6 cases, aortic transposition in 4 cases, right ventricular 3 cases of double outlet, 2 cases of left ventricular dysplasia of mitral valve atresia, 2 cases of tricuspid regurgitation, 2 cases of pulmonary venous drainage, 3 cases of single atrium, 1 case of single ventricle and 2 cases of right aortic arch. 2 cases of arterial stenosis, 2 cases of stenosis of main pulmonary artery, 1 case of stenosis of pulmonary valve, 1 case of permanent arterial trunk and 1 case of atrial septal bulbar tumor. All pre-natal diagnosis by the superior hospital or autopsy and post-natal follow-up confirmed. Conclusion: Ultrasound examination of fetal heart in different stages of application, can complement each other to minimize the misdiagnosis and missed diagnosis of fetal congenital heart disease.