CAJ | 학술논문

目的探讨产前超声诊断胎儿动脉导管狭窄的临床价值及其对临床分娩的指导意义.方法回顾性分析产前超声诊断的12例动脉导管狭窄胎儿的超声表现及围产结局,总结其声像图特点.结果 12例胎儿动脉导管管腔细窄,内径1.6～2.1 mm,彩色多普勒显示动脉导管内呈五彩血流,频谱多普勒呈单峰连续递减型高速分流频谱,收缩期峰值血流速度256～404 cm/s,舒张末期血流速度90～205 cm/s;12例胎儿均伴有右心房、室扩大,肺动脉增宽,三尖瓣中重度反流,最大反流速度324～515 cm/s,最大跨瓣压差41～106 mmHg.7例胎儿急诊剖宫产分娩,5例胎儿催产素引产分娩.12例新生儿中11例为足月儿,1例为早产儿,出生后经1～3月的超声心动图随访,心脏结构及功能均恢复正常.结论产前超声诊断胎儿动脉导管狭窄具有重要临床价值,并能评估胎儿右心功能,对指导临床分娩具有重要意义.
목적 탐토산전초성진단태인동맥도관협착적림상개치급기대림상분면적지도의의.방법 회고성분석산전초성진단적12례동맥도관협착태인적초성표현급위산결국,총결기성상도특점.결과 12례태인동맥도관관강세착,내경1.6～2.1 mm,채색다보륵현시동맥도관내정오채혈류,빈보다보륵정단봉련속체감형고속분류빈보,수축기봉치혈류속도256～404 cm/s,서장말기혈류속도90～205 cm/s;12례태인균반유우심방、실확대,폐동맥증관,삼첨판중중도반류,최대반류속도324～515 cm/s,최대과판압차41～106 mmHg.7례태인급진부궁산분면,5례태인최산소인산분면.12례신생인중11례위족월인,1례위조산인,출생후경1～3월적초성심동도수방,심장결구급공능균회복정상.결론 산전초성진단태인동맥도관협착구유중요림상개치,병능평고태인우심공능,대지도림상분면구유중요의의.
Objective To study the clinical value of prenatal ultrasound in diagnosis of fetal ductus arteriosus stenosis and the guiding significance for clinical delivery.Methods Ultrasound images and perinatal outcome of 12 cases of ductus arteriosus stenosis diagnosed by prenatal ultrasound were retrospectively analysed,the sonographic features were summarized.Results Fetal ductus arteriosus was thin in 12 cases with inner diameter of 1.6 - 2.1 mm.Color Doppler flow imaging showed multicolored blood flow in ductus arteriosus,spectral Doppler showed single peak continuous decreasing high-speed shunt spectrum,peak systolic velocity 256- 404 cm/s,end diastolic velocity 90 - 205 cm/s.Twelve fetuses were associated with right atrial and ventricular dilatation,pulmonary artery widened and moderate to severe tricuspid regurgitation,maximum reflux velocity 324 - 515 cm/s,maximum transvalvular pressure gradient 41 - 106 mmHg.There were 7 cases of emergency cesarean section delivery and 5 cases of oxytocin induced labor delivery,11 cases were full-term infants and 1 case was premature infant.12 fetuses were followed-up after birth by 1 to 3 months of echocardiography until the cardiac structure and function returned to normal,Conclusions Prenatal ultrasound has important clinical value in diagnosis of fetal ductus arteriosus stenosis,it is helpful to assess the fetal right heart function and guide the clinical delivery.