中华超声影像学杂志
中華超聲影像學雜誌
중화초성영상학잡지
CHINESE JOURNAL OF ULTRASONOGRAPHY
2014年
11期
979-982
,共4页
超声检查 ,产前%胎儿%三尖瓣闭锁不全%随访研究
超聲檢查 ,產前%胎兒%三尖瓣閉鎖不全%隨訪研究
초성검사 ,산전%태인%삼첨판폐쇄불전%수방연구
Ultrasonography,prenatal%Fetus%Tricuspid valve insufficiency%Follow-up studies
目的：探讨胎儿功能性三尖瓣反流的超声随访价值。方法选择中度及以上三尖瓣反流、压差大于20 mmHg（1 mmHg＝01．33 kPa）、右房右室增大的44例胎儿进行观察。自孕24周至胎儿出生后9周，每4周观测一次三尖瓣反流速度、反流压差、心腔大小、有无心包腔或胸腔积液等。结果44例中有18例（409．％）在出生前好转；25例（568．％）于出生1～62 d后三尖瓣反流消失或转为极轻度，其中3例出生前反流速度达42． m／s以上，压差达70 mmHg以上，出现心力衰竭征象，提前出生后逐渐恢复正常；1例（23．％）于出生后因中度三尖瓣持续反流并发严重右心衰竭经治疗无效死亡。结论功能性三尖瓣高速反流绝大部分预后良好。当胎儿三尖瓣反流压差超过70 mmHg或有右心衰竭征象时应提前分娩，以防宫内意外发生。
目的：探討胎兒功能性三尖瓣反流的超聲隨訪價值。方法選擇中度及以上三尖瓣反流、壓差大于20 mmHg（1 mmHg＝01．33 kPa）、右房右室增大的44例胎兒進行觀察。自孕24週至胎兒齣生後9週，每4週觀測一次三尖瓣反流速度、反流壓差、心腔大小、有無心包腔或胸腔積液等。結果44例中有18例（409．％）在齣生前好轉；25例（568．％）于齣生1～62 d後三尖瓣反流消失或轉為極輕度，其中3例齣生前反流速度達42． m／s以上，壓差達70 mmHg以上，齣現心力衰竭徵象，提前齣生後逐漸恢複正常；1例（23．％）于齣生後因中度三尖瓣持續反流併髮嚴重右心衰竭經治療無效死亡。結論功能性三尖瓣高速反流絕大部分預後良好。噹胎兒三尖瓣反流壓差超過70 mmHg或有右心衰竭徵象時應提前分娩，以防宮內意外髮生。
목적：탐토태인공능성삼첨판반류적초성수방개치。방법선택중도급이상삼첨판반류、압차대우20 mmHg（1 mmHg＝01．33 kPa）、우방우실증대적44례태인진행관찰。자잉24주지태인출생후9주，매4주관측일차삼첨판반류속도、반류압차、심강대소、유무심포강혹흉강적액등。결과44례중유18례（409．％）재출생전호전；25례（568．％）우출생1～62 d후삼첨판반류소실혹전위겁경도，기중3례출생전반류속도체42． m／s이상，압차체70 mmHg이상，출현심력쇠갈정상，제전출생후축점회복정상；1례（23．％）우출생후인중도삼첨판지속반류병발엄중우심쇠갈경치료무효사망。결론공능성삼첨판고속반류절대부분예후량호。당태인삼첨판반류압차초과70 mmHg혹유우심쇠갈정상시응제전분면，이방궁내의외발생。
Objective To explore the follow‐up value of ultrasound in fetal tricuspid regurgitation . Methods 44 fetuses who presented with moderate tricuspid regurgitation with differential pressure over 20 mmHg ,dilation of right atria and ventricles were chosen as the observation group .Examinations ,in terms of the degree ,velocity and differential pressure of reflux ,size of heart chamber and the presence pericardial or pleural effusion were carried out once every four weeks from 24 weeks of pregnancy to 9 weeks after birth . Results 40 9.% (18/44) of cases had been getting better before birth .The degree of regurgitation of 56 8.%(25/44) cases significantly decreased or even disappeared from 1 to 62 days after birth .Especially ,3 cases whose regurgitation velocity reached to 4 2. m/s with the differential pressure over 70 mmHg as well as onset of heart failure symptoms had been recovered gradually after born in advance 1. case (2 3.% ) with the persistence of both tricuspid regurgitation and heart failure symptoms after birth died in right heart failure , even though using different active treatments ,such as oxygen ,strong heart and diuresis .Conclusions High‐speed tricuspid regurgitation in fetuses without pathological changes can be almost reversed ,and the prognosis is good .Once the fetal tricuspid regurgitation pressure is over 70 mmHg or a fetus appears the onset of heart failure symptoms ,pre‐term delivery should be advised in a bid to prevent accidents in uterine cavity .
