Yagel法在产前超声诊断胎儿先天性心脏病的临床研究

目的通过应用Yagel法胎儿心脏超声检查探讨产前超声诊断胎儿先天性心脏病的可行性及临床应用价值。方法收集2008年2月—2010年2月在我院行产前胎儿超声检查的孕妇共4415例,孕周20～36周。应用Yagel法筛查4415例胎儿先天性心脏病的发生情况。Yagel法筛查切面包括：①胎儿腹部胃泡横切面;②四腔心切面;③五腔心切面;④大动脉短轴切面;⑤三血管气管切面。随访胎儿预后,计算Yagel法诊断胎儿先天性心脏病的敏感度及特异度。结果 4415例胎儿中,应用Yagel法诊断先天性心脏病共18例：①室间隔缺损5例;②房室间隔缺损3例;③肺动脉瓣狭窄1例;④复杂性先天性心脏病9例：右室双出口、完全性大动脉转位、永存动脉干各3例;漏诊2例,误诊1例,先天性心脏病的发病率0.45%（20/4415）。Yagel法诊断先天性心脏病的敏感度90%（18/20）,特异度99.9%（4394/4395）。结论 Yagel法胎儿心脏超声检查是产前筛查和诊断胎儿先天性心脏病的简单、有效的方法,具有良好的临床应用前景。

STUDY OF YAGEL'S HEART EXAMINATION METHOD ON PRENATAL DIAGNOSIS OF CONGENITAL FETAL HEART DISEASES

Objective To approach the feasibility and investigate the value of clinicial significicance of congenital heart diseases（CHD） by Yagel＇s heart examination method. Methods A total of 4415 fetus were included. The fental hearts were scanned by ultrasoud.Fetal heart screening based on five views：①a transverse section of the upper abdomen; ②four chamber section; ③the five chamber section; ④the bifurcation of the arteries; ⑤the three vessel and trchea plane. The sensitivity and specificity of Yagel＇s heart examination method was evaluated. Follow-up data of newborn was obstained. Results Among 4415 cases,18 cases with CHD were diagnosed using Yagel＇s heart examination method,inculding：①5 ventricular septal defect（VSD）; ②3 atro-ventricular septal defect （AVSD）;③1 pulmonary valve stenosis（PS）; ④9 complecated CHD：3 double outlet right ventricle（DORV）; 3 transposion of the great arteries （TGA）; 3 truncus arteriosus（TA）.2 cases were missed diagnosis,and 1 case was misdiagnosed.The incidence of CHD was 0.45 %. The sensitivity of Yagel＇s heart examination method was 90%（18/20）,and the specificity was 99.9% （4394/4395）. Concluson Yagel＇s heart examination is an effective and time-saving method for prenatal daigonosis of CHD.