中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2015年
25期
120-122
,共3页
产前诊断%先天性心脏畸形%超声
產前診斷%先天性心髒畸形%超聲
산전진단%선천성심장기형%초성
Prenatal diagnosis%Congenital heart malformations%Ultrasound
目的：探讨先天性心脏畸形（CHD）多普勒超声检查的诊断特点。方法：回顾性分析6982例孕妇中61例确诊为先天性心脏畸形胎儿的临床资料，分析CHD胎儿合并心内畸形、心外畸形及染色体异常的特点。结果：61例孕妇胎儿产前诊断异常中，房室间隔缺损所占比例最高，为44.3%，其他依次为肺动脉狭窄（13.1%）、大动脉转位（TGA）（11.5%）、右位主动脉弓（9.8%）、法络四联症（8.2%）、主动脉瓣闭锁或者狭窄（8.2%）、主动脉缩窄（6.6%）等，61例胎儿先天性心脏畸形中11例为心脏单发畸形，占比18.0%，20例为心脏复发畸形，占比32.8%；合并心外畸形41例，占比67.2%，合并染色体异常28例，占比45.9%；61例CHD胎儿家属同意引产有56例，追踪上级医院尸检结果或产后与产前诊断完全符合54例，占比98.2%，2例疑似主动脉缩窄胎儿产后尸检证实为主动脉弓中断，占比3.6%，出生的5例新生儿中3例符合产前诊断，超声诊断的完全符合率为93.4%（57/61），误诊率为6.6%（4/61）。结论：胎儿CHD常合并有其他心内畸形、心外畸形及染色体异常，超声检查在CHD诊断中准确度高，有重要的价值。
目的：探討先天性心髒畸形（CHD）多普勒超聲檢查的診斷特點。方法：迴顧性分析6982例孕婦中61例確診為先天性心髒畸形胎兒的臨床資料，分析CHD胎兒閤併心內畸形、心外畸形及染色體異常的特點。結果：61例孕婦胎兒產前診斷異常中，房室間隔缺損所佔比例最高，為44.3%，其他依次為肺動脈狹窄（13.1%）、大動脈轉位（TGA）（11.5%）、右位主動脈弓（9.8%）、法絡四聯癥（8.2%）、主動脈瓣閉鎖或者狹窄（8.2%）、主動脈縮窄（6.6%）等，61例胎兒先天性心髒畸形中11例為心髒單髮畸形，佔比18.0%，20例為心髒複髮畸形，佔比32.8%；閤併心外畸形41例，佔比67.2%，閤併染色體異常28例，佔比45.9%；61例CHD胎兒傢屬同意引產有56例，追蹤上級醫院尸檢結果或產後與產前診斷完全符閤54例，佔比98.2%，2例疑似主動脈縮窄胎兒產後尸檢證實為主動脈弓中斷，佔比3.6%，齣生的5例新生兒中3例符閤產前診斷，超聲診斷的完全符閤率為93.4%（57/61），誤診率為6.6%（4/61）。結論：胎兒CHD常閤併有其他心內畸形、心外畸形及染色體異常，超聲檢查在CHD診斷中準確度高，有重要的價值。
목적：탐토선천성심장기형（CHD）다보륵초성검사적진단특점。방법：회고성분석6982례잉부중61례학진위선천성심장기형태인적림상자료，분석CHD태인합병심내기형、심외기형급염색체이상적특점。결과：61례잉부태인산전진단이상중，방실간격결손소점비례최고，위44.3%，기타의차위폐동맥협착（13.1%）、대동맥전위（TGA）（11.5%）、우위주동맥궁（9.8%）、법락사련증（8.2%）、주동맥판폐쇄혹자협착（8.2%）、주동맥축착（6.6%）등，61례태인선천성심장기형중11례위심장단발기형，점비18.0%，20례위심장복발기형，점비32.8%；합병심외기형41례，점비67.2%，합병염색체이상28례，점비45.9%；61례CHD태인가속동의인산유56례，추종상급의원시검결과혹산후여산전진단완전부합54례，점비98.2%，2례의사주동맥축착태인산후시검증실위주동맥궁중단，점비3.6%，출생적5례신생인중3례부합산전진단，초성진단적완전부합솔위93.4%（57/61），오진솔위6.6%（4/61）。결론：태인CHD상합병유기타심내기형、심외기형급염색체이상，초성검사재CHD진단중준학도고，유중요적개치。
Objective: To explore the diagnosis and clinical analysis of prenatal diagnosis in congenital heart disease.Method: To retrospectively analyze heart malformations, cardiac malformations, and chromosomal abnormalities features in CHD fetal of 61 pregnant women diagnosed with congenital heart disease (CHD) fetal clinical data in 6982 pregnant women.Result: The atrioventricular septal defect was highest proportion accounting for 44.3% in 61 CHD fetal. Followed by the pulmonary stenosis (13.1%), transposition of great arteries (TGA) (11.5%) and right aortic arch (9.8%) law network of Fallot (8.2%) aortic atresia and stenosis (8.2%) aortic coarctation (6.6%), etc. 11 cases with cardiac malformations single, accounting for 18.0% in 61 cases with congenital heart diseases, 20 cases with recurrent cardiac malformation, accounting for 32.8%. The combined cardiac abnormalities were 41 cases, accounting for 67.2%, the combined chromosomal abnormalities in 28 cases, accounting for 45.9%; 61 cases of CHD contained 56 cases with fetal abortion consent of their families, and to track higher hospital autopsy results or postpartum and prenatal diagnosis in full compliance with 54 cases, accounted for 98.2%, two cases of suspected aortic coarctation postnatal fetal autopsy confirmed interrupted aortic arch, accounting for 3.6% of the 5 cases of newborns born three cases in line with prenatal diagnosis, ultrasound diagnosis rate was 93.4% in full compliance with (57/61), the misdiagnosis rate was 6.6%(4/61).Conclusion: Fetal CHD is often associated with other cardiac malformations, malformations and chromosomal abnormalities, ultrasound and high accurate in the diagnosis of cardiac CHD, there is an important value.
