超声心动图下胎儿先天性心脏病的疾病分布状况分析

目的 探讨超声心动图下胎儿先天性心脏病的疾病分布状况。方法 收集2009-2013年行胎儿超声心动图检查的15 648例孕妇的临床资料,其中诊断患有胎儿先天性心脏病的孕妇419例,根据胎儿心脏超声检查结果对疾病分布状况进行分析,并与引产者胎儿尸解结果或出生后新生儿超声心动图诊断结果比较。结果 419例行新生儿超声心动图检查或尸检确诊,其中398例得到确诊,另外21例无异常,准确率为95.0%。产前诊断与产后确诊差异无统计学意义（P〉0.05）,产前诊断的4例左心室发育不良综合征产后确诊为主动脉瓣狭窄,5例动脉单干产后诊断为肺动脉闭锁,3例动脉单干诊断为重型法洛四联征,3例右心室双出口产后诊断为大血管转位,根据产后确诊结果分析,其中畸形比例最多的为肺动脉闭锁,占24.37%,再次为法洛四联征,为15.08%,其次为单纯性室间隔缺损,为13.31%。结论 超声心动图能有效诊断胎儿先天性心脏病,并能对常见的先天性心脏病准确诊断,对后期的治疗方案具有重要的指导意义。

Analysis of the distribution of fetal congenital heart disease by echocardiography

Objective To investigate the distribution of fetal congenital heart disease by echocar-diography. Methods Clinical data of 15 648 cases of pregnant women underwent fetal echocardiography were collected from 2009 to 2013, with 419 cases pregnant women diagnosed with fetal congenital heart dis-ease. Disease distribution was analyzed according to fetal cardiac ultrasound, and compared with autopsy re-sults of fetus from induced labor or echocardiographic diagnosis results from newborn. Results 419 cases of newborns echocardiography or autopsy were performed, of which 398 cases were confirmed, and the other 21 cases were not abnormal. The accuracy was 95.0%. There was no significant difference between the prenatal diag-nosis and postnatal confirmed （P〉0.05）. 4 cases of left ventricular dysplasia syndrome in prenatal diagnosis were diagnosed as arterial stenosis after birth. 5 cases of artery alone were diagnosed as pulmonary atresia after birth. 3 cases of arterial alone were diagnosed as severe tetralogy of Fallot after birth, 3 cases of double outlet right ventri-cle were postnatal diagnosed as the great vessels. According to the results of postnatal diagnosis analysis, pulmo-nary atresia accounted for the highest percentage of deformity with 24.37%, then tetralogy of Fallot acounted for 15.08%, followed by simple ventricular septal defect with 13.31%. Conclusion Echocardiography is valuable in the diagnosis of fetal congenital heart disease, which could provide an important guiding to the treatment.