基层医院产前胎儿心脏超声筛查漏诊情况分析

目的探讨深圳地区基层医院产前胎儿心脏超声筛查常见漏诊疾病及原因。方法对我院在基层医院初诊中漏诊胎儿心脏畸形的会诊病例103例以四腔心、左右心室流出道和三血管气管切面为基本筛查切面进行产前胎儿心脏超声筛查,分析深圳地区基层医院胎儿心脏畸形的常见漏诊情况。结果本组四腔心切面遗漏左位上腔静脉33例,完全性肺静脉异位回流11例;左右心室流出道切面漏诊12例法洛四联征,6例永存动脉干,5例右室双出口,5例肺动脉瓣闭锁;三血管气管切面漏诊迷走锁骨下动脉20例,主动脉弓离断7例,主动脉弓缩窄4例。结论各个筛查标准切面细节观察不足是深圳地区基层医院漏诊胎儿心脏畸形的主要原因。

Missed Diagnosis of Ultrasonic Screening for Fetal Heart Malformations in Primary Hospitals

Objective To explore causes of missed diagnosis of major diseases by ultrasonic screening for fetal heart malformations in primary hospitals in Shenzhen. Methods A total of 103 missed diagnosis cases of fetal heart malformations at first visit in primary hospitals undertook ultrasonic screening for fetal heart malformations with four-chamber view （4CV） , left and right ventricular outflow views and three vessels and trachea view as standard screening, and situation of common missed diagnosis in primary hospitals in Shenzhen was also analyzed. Results Thirty-three cases of persistence of left superi- or vena cava and 11 cases of complete anomalous pulmonary venous return were of missed diagnosis by 4CV; 12 cases of tet- ralogy of fallot, 6 eases of persistent truncus arteriosus, 5 cases of double-outlet right ventricle, 5 cases of pulmonary atresia were of missed diagnosis by left and right ventricular outflow views ; 20 cases of aberrant subclavian artery, 7 cases of interrup- tion of aortic arch and 4 eases of coarctation were missed diagnosis by three vessels and trachea view. Conclusion Lake of detailed observation by each standard view in primary hospitals in Shenzhen is the main cause of missed diagnoses for fetal car- diac screening.