中国妇幼健康研究
中國婦幼健康研究
중국부유건강연구
Chinese Journal of Woman and Child Health Research
2015年
4期
818-820,839
,共4页
唐氏筛查%超声心动图%先天性心脏病%胎儿
唐氏篩查%超聲心動圖%先天性心髒病%胎兒
당씨사사%초성심동도%선천성심장병%태인
Down' s screening%echocardiogram%congenital heart disease%fetus
目的 探讨胎儿超声心动图在唐氏筛查高危胎儿先天性心脏畸形中的诊断作用. 方法 收集2012年11月至2014年11月间共4 875例妊娠22~28周的孕妇,依据唐氏筛查结果将其分为高风险、低风险、未检查3组. 选用胎儿超声心动图软件,应用局部放大功能,采用心脏四腔心观、五腔心观、左右室流出道观、大血管短轴观、上下腔静脉及三血管-气管平面观,判断胎儿是否发生先天性心脏病. 结果 在4 875例受检者中,唐氏筛查低风险者3 656例,高风险者147例(21-三体103例, 18-三体36例,Turner8例) ,其余1 072未进行染色体检查. 超声心动图提示在合并有先天性心脏病的胎儿中,唐氏筛查高风险组的引产率明显高于低危组(χ2 =5.08,P=0.02). 唐氏筛查高风险组的先天性心脏病发生率显著高于低风险组(χ2 =718.89, P=0.00). 结论 唐氏筛查高风险组中21-三体者多见,存在染色体核型异常的发生率也较高. 超声心动图检查发现,高风险组的心脏畸形发生率远高于低风险组. 及早对唐氏筛查高危患者进行产前检查,对减少围产期胎儿死亡具有重要意义.
目的 探討胎兒超聲心動圖在唐氏篩查高危胎兒先天性心髒畸形中的診斷作用. 方法 收集2012年11月至2014年11月間共4 875例妊娠22~28週的孕婦,依據唐氏篩查結果將其分為高風險、低風險、未檢查3組. 選用胎兒超聲心動圖軟件,應用跼部放大功能,採用心髒四腔心觀、五腔心觀、左右室流齣道觀、大血管短軸觀、上下腔靜脈及三血管-氣管平麵觀,判斷胎兒是否髮生先天性心髒病. 結果 在4 875例受檢者中,唐氏篩查低風險者3 656例,高風險者147例(21-三體103例, 18-三體36例,Turner8例) ,其餘1 072未進行染色體檢查. 超聲心動圖提示在閤併有先天性心髒病的胎兒中,唐氏篩查高風險組的引產率明顯高于低危組(χ2 =5.08,P=0.02). 唐氏篩查高風險組的先天性心髒病髮生率顯著高于低風險組(χ2 =718.89, P=0.00). 結論 唐氏篩查高風險組中21-三體者多見,存在染色體覈型異常的髮生率也較高. 超聲心動圖檢查髮現,高風險組的心髒畸形髮生率遠高于低風險組. 及早對唐氏篩查高危患者進行產前檢查,對減少圍產期胎兒死亡具有重要意義.
목적 탐토태인초성심동도재당씨사사고위태인선천성심장기형중적진단작용. 방법 수집2012년11월지2014년11월간공4 875례임신22~28주적잉부,의거당씨사사결과장기분위고풍험、저풍험、미검사3조. 선용태인초성심동도연건,응용국부방대공능,채용심장사강심관、오강심관、좌우실류출도관、대혈관단축관、상하강정맥급삼혈관-기관평면관,판단태인시부발생선천성심장병. 결과 재4 875례수검자중,당씨사사저풍험자3 656례,고풍험자147례(21-삼체103례, 18-삼체36례,Turner8례) ,기여1 072미진행염색체검사. 초성심동도제시재합병유선천성심장병적태인중,당씨사사고풍험조적인산솔명현고우저위조(χ2 =5.08,P=0.02). 당씨사사고풍험조적선천성심장병발생솔현저고우저풍험조(χ2 =718.89, P=0.00). 결론 당씨사사고풍험조중21-삼체자다견,존재염색체핵형이상적발생솔야교고. 초성심동도검사발현,고풍험조적심장기형발생솔원고우저풍험조. 급조대당씨사사고위환자진행산전검사,대감소위산기태인사망구유중요의의.
Objective To explore the role of fetal echocardiogram in diagnosis of congenital heart disease in high-risk fetus detected in Down' s screening.Methods From November 2012 to November 2014 totally 4 875 pregnant women at gestational age of 22-28 weeks were divided into high-risk group, low-risk group and unexamined group according to Down' s screening results.By using zoom technique, fetal echocardiogram software was used to judge whether congenital heart diseases developed from the views of four chamber, five chamber, long axis view, short axis view, superior and inferior vena cava and three-vessel-trachea view.Results In 4 875 detected cases, 3 656 were classified into low-risk group and 147 were classified into high-risk group (103 cases of trisomy 21, 36 cases of trisomy 18, 8 cases of Turner) .The other 1 072 cases did not take Down's screening.Echocardiography indicated that among fetuses complicated with congenital heart disease the abortion rate in high-risk group was significantly higher than in low-risk group (χ2 =5.08,P=0.02).The incidence of congenital heart disease in high-risk group was obviously higher than that in low-risk group (χ2 =718.89, P=0.00) .Conclusion In high-risk group trisomy 21 is common and the incidence of chromosome abnormalities is higher.Echocardiography shows that the incidence of cardiac anomalies is remarkably higher in high-risk group than in low-risk group.Early prenatal examination for high-risk fetuses screened in Down's screening is of great importance for reducing perinatal mortality.
