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目的探讨胎儿超声心动图用于先天性心脏病产前诊断中的临床价值。方法选取2014年6月-2015年6月来我院常规进行产前胎儿超声心动图检查的7269例孕妇为研究对象,采用七切面顺序分段法对胎儿的心脏进行检查,最终以产后新生儿超声心动图或是尸检结果作为诊断的金标准,分析产前行超声心动图检查对胎儿先天性心脏病的诊断价值。结果7269例孕妇中,共发现15例胎儿先天性心脏病,其中,法洛四联症在所有畸形中所占比例最高,为26.67%,其他依次为完全性心内膜垫缺损(20%)、完全性大动脉转位(6.67%)、右室双出口(6.67%)、左心发育不良(6.67%)、主动脉瓣狭窄(6.67%)等。其中复杂先天性心脏病及部分合并心外畸形者10例,占66.67%;单纯性室间隔缺损2例;主动脉瓣狭窄1例;漏诊2例II型房间隔缺损。结论产前胎儿超声心动图能较准确评估胎儿心脏结构,分辨心脏畸形类型,特异性高,值得应用;排除胎位等多种影响因素有利于降低漏诊率。
Objective To investigate the clinical value of fetal echocardiography in prenatal diagnosis of congenital heart disease. Methods A total of 7269 pregnant women with prenatal fetal echocardiography in our hospital from June 2014 to June 2015 were selected as the study subjects. The heart of the fetus was examined by seven-section sequential segmentation method. Finally, the newborn Echocardiography or autopsy results as the gold standard for diagnosis, analysis of prenatal echocardiography in the diagnosis of fetal congenital heart disease. Results Among 7269 pregnant women, 15 cases of fetal congenital heart disease were found. Among them, tetralogy of Fallot had the highest proportion of all deformities, accounting for 26.67%, followed by complete endocardial cushion defect (20%), , Complete aortic transposition (6.67%), right ventricular double outlet (6.67%), left ventricular dysplasia (6.67%), aortic valve stenosis (6.67%) and so on. Complicated congenital heart disease and some cases of extra-cardiac malformations in 10 cases, accounting for 66.67%; simple ventricular septal defect in 2 cases; aortic stenosis in 1 case; missed diagnosis of 2 cases of type II atrial septal defect. Conclusions Prenatal fetal echocardiography can accurately evaluate the fetal heart structure, identify the type of cardiac malformations, and have high specificity. It is worthwhile to apply prenatal fetal echocardiography. Elimination of multiple influencing factors such as fetal position can reduce the rate of misdiagnosis.