CAJ | 학술논문

目的探讨单心室在胎儿期的常见类型、合并畸形和超声心动图检查中应注意的问题.方法选择我院胎儿超声心动图检查明确诊断的先天性心脏病345例中单心室73例,其中双胎3例.采用全面、系统的多切面胎儿超声心动图连续扫查法,并进行鉴别诊断.结果 73例单心室中单纯性3例,合并单心房44例,合并单心房并永存动脉干18例、肺动脉闭锁2例,合并单心房并肺动脉口狭窄20例、部分型房室隔缺损4例、主动脉或瓣膜发育不良3例.单心室分型:A型24.7％,B型13.7％,C型46.6％,D型15.0％;主动脉右转位68.2％；共同流入型单心室45.2％,单流入型42.5％,双流入型12.3％.终止妊娠42例,病理证实11例,失访31例.结论胎儿单心室病例中合并畸形发生率较高；分型中以混合型C型及主动脉右转位最多见；超声心动图检查中应注意心腔内粗大乳头肌和异常肌束与室间隔的鉴别,避免漏诊.
목적 탐토단심실재태인기적상견류형、합병기형화초성심동도검사중응주의적문제.방법 선택아원태인초성심동도검사명학진단적선천성심장병345례중단심실73례,기중쌍태3례.채용전면、계통적다절면태인초성심동도련속소사법,병진행감별진단.결과 73례단심실중단순성3례,합병단심방44례,합병단심방병영존동맥간18례、폐동맥폐쇄2례,합병단심방병폐동맥구협착20례、부분형방실격결손4례、주동맥혹판막발육불량3례.단심실분형:A형24.7％,B형13.7％,C형46.6％,D형15.0％;주동맥우전위68.2％；공동류입형단심실45.2％,단류입형42.5％,쌍류입형12.3％.종지임신42례,병리증실11례,실방31례.결론 태인단심실병례중합병기형발생솔교고；분형중이혼합형C형급주동맥우전위최다견；초성심동도검사중응주의심강내조대유두기화이상기속여실간격적감별,피면루진.
Objective To improve detection rate and diagnostic accuracy of single ventricle(SV) in obstetric fetal echocardiography,to investigate the common types and complicated malformations of SV in the fetus,and to summarize the differential announcements in diagnosing fetal SV.Methods In 345 fetal hearts which were diagnosed as congenital heart disease by fetal echocardiography in our hospital,73 cases diagnosed as SV,including 3 cases appeared as ones of twins,were included in this study.Systemic scanning and multiple-views fetal echocardiography were used to examine these enrolled fetuses.Results In all 73 SV eases,3 cases were diagnosed as simple SV,the others were diagnosed as SV accompanied with other abnormalities,among them 44 cases accompanied with single atrium,18 cases with single atrium and persistent truncus arteriosus,2 cases with pulmonary atresia,20 cases with pulmonary artery stenosis,4 cases with partial atrioventricular septal defect,3 eases with aorta dysplasia or aortic valve dysplasia.SV types were classified as 24.7％ in type A,13.7％ in type B,46.6％ in type C and 15.0％ in type D respectively.68.2％ of the cases were diagnosed with aortic D-transposition,and 45.2 ％ with common inlet,42.5 ％ with single inlet and 12.3 ％ with double inlet respectively.42 SV cases were executed termination of pregnancy which 11 cases were confirmed by pathology and the other 31 cases were out of following-up.Conclusions Most cases of fetal SV were accompanied other abnormalities and simple SV was rare.Type C in which ventricular structure was combined with left and right ventricle was the most common type.To avoid the false diagnosis,much attention must be paid to distinguish big papillary muscle and abnormal muscle bundle from interventricular septum during ultrasonic examination.