频谱多普勒及M-型超声心动图检测胎儿心律失常的临床研究

目的：探讨频谱多普勒及M-型超声心动图对胎儿心律失常的诊断价值。方法：采用彩色多普勒超声心动图对孕龄16～41周的临床疑诊胎儿心律失常或存在其他异常的226例胎儿进行研究。结果：共检出胎儿心律失常53例(23．5％)，其中期前收缩40例(房性期前收缩35例，室性期前收缩5例包括室性早搏二联律、室性早搏三联律各1例)。心动过缓7例，心动过速4例，2：1房室传导阻滞、房扑各1例。53例心律失常胎儿中并发先天性心血管畸形4例(二尖瓣闭锁1例，共同房室通道1例，单心室伴肺动脉瓣狭窄1例，心脏肿瘤1例)。结论：胎儿频谱多普勒及M-型超声心动图是检出胎儿心律失常的可靠的无创性影像诊断技术，其应用有助于早期检出并指导心律失常胎儿的处置。

Clinical Applications of Spectral Doppler and M-mode Echocardiography in Detecting Fetal Arrhythmias

Objective:To investigate the applications of spectral Doppler and M-mode echocardiography in detection of fetal arrhythmias.Methods:Fetal echocardiography was performed in 226 fetuses for evaluation of fetal heart structures and arrhythmias and two-dimensional,M-mode,color M-mode and pulsed Doppler echocardiography were used.Results:Fifty-three fetuses were documented with fetal arrhythmias.The commonest fetal arrhythmia encountered were extrasystoles in 40 cases:atrial extrasystoles in 35,ventricular extrasystoles in 5 cases including 1 case with bigeminy and 1 case with trigeminy.Tachycardia was found in 4 cases, brachycardia in 7 cases,2:1 atrioventricular block in 1 case and atrial flutter in 1 case.There were 4 fetuses with arrhythmias and structural heart diseases.Conclusions:Fetal spectral Doppler and M-mode echocardiography play important roles in prenatal evaluation and therapeutic orientation of fetal arrhythmias.