彩色多普勒超声在非高危胎儿产前心脏筛查中的临床价值

目的探讨彩色多普勒超声在非高危胎儿产前心脏筛查中的临床诊断价值，以便尽可能地降低先天性心脏病患儿的出生率及围生儿死亡率。方法回颐性分析2009年6月～2011年12月解放军第四二一医院联合应用左、右室流出道切面和四腔心切面法对孕18～24周的非高危胎儿进行心脏筛查的3780例临床资料。结果经引产尸解及产后随访证实，本组共检出先天性心脏病胎儿26例（其中严重先天性脏病12例），心脏畸形的总发生率为6．9‰。24例经产前多普勒超声筛查检出，漏诊2例（法洛四联症1例、室间隔缺损1例），产前超声检出率为92．3％。结论彩色多普勒超声能获得较满意的胎儿心脏声像，胎心结构清楚，能检出大多数胎儿心脏畸形．是产前筛查胎儿先天性心脏病的首选方法，在非高危胎儿产前心脏筛查中有重要的临床价值。

Clinical value of color Doppler ultrasound in prenatal cardiac screening of non-high risk fetus

Objective To investigate the clinical diagnostic value of color Doppler ultrasound in prenatal cardiac screening of non-high risk fetus, so as to reduce the birth rate of neonate with congenital heart disease and perineonate mortality as much as possible. Methods The clinical materials of 3780 non-high risk fetus in gestational period of 18-24 weeks monitored in the 421st Hospital of PLA from July 2009 to December 2011 were retrospectively an- alyzed. These fetuses were screened by combination of left and right ventricular outflow tract section, and four-cham- ber heart section methods. Results Confirmed by induced labor fetus autopsy and post-natal follow-up, 26 fetus with congenital heart disease were founded （including 12 cases of severe congenital heart disease）, the overall incidence of cardiac malformations was 6.9%v; twenty-four cases were confirmed by prenatal Doppler ultrasound screening, two cas- es （1 case of tetralogy of Fallot, 1 case of ventricular septal defect） were missed, prenatal ultrasound detection rate of 92.3%. Conclusion Color Doppler ultrasound can obtain satisfactory fetal heart sonographic image with clear fetal heart structure, can detect most fetal cardiac malformations, is the preferred method of prenatal screening for fetal congenital heart disease, and has important clinical value in non-high-risk prenatal fetal heart screening.