论文部分内容阅读
目的探讨超声心动图测定心脏轴变化在胎儿先天性心脏病（先心病）产前诊断中的临床意义。方法应用Ａｃｕｓｏｎ１２８×Ｐ／１０彩色多普勒超声诊断仪检查５１８例胎龄１８～４０周的先心病高危胎儿和９０例正常胎儿，在心脏超声四腔观基础上测定胎儿心脏轴，并从多切面观察胎儿心内结构，以确定胎儿有无先心病。结果正常胎儿心脏轴为（４４．８±１０．３）度，先心病胎儿心脏轴为（５８．１±１５．７）度，两者比较，差异有显著性（Ｐ＜０．０１）。单纯四腔观检测胎儿先心病的敏感性为６８．５％，应用心脏超声四腔观加心脏轴测定检测胎儿先心病的敏感性为９１．４％，两者比较，差异有显著性（Ｐ＜０．０５）；５１８例先心病高危胎儿中，产前超声正确诊断先心病３４例，假阳性１例，假阴性１例。结论正常胎儿心脏轴范围２０～７５度，如心脏轴＞７５度，应高度怀疑胎儿先心病；心脏轴测定在胎儿先心病筛查中具有重要作用，可作为一种常规测量指标。
Objective To investigate the clinical significance of echocardiography in the prenatal diagnosis of fetal congenital heart disease (CHD). Methods A total of 518 high-risk fetuses with gestational age 18 to 40 weeks and 90 normal fetuses were examined by Acuson128 × P / 10 color Doppler sonography. The fetal heart axis was measured on the basis of four-chamber echocardiography. Fetal observation of the fetal heart structure, in order to determine whether the fetus congenital heart disease. Results The normal fetal heart axis was (44.8 ± 10.3) degrees and the concentric heart axis was (58.1 ± 15.7) degrees. There was a significant difference between the two groups (P <0.01). The sensitivity of simple four-chamber examination of fetal congenital heart disease was 68.5%. The sensitivity of four-chamber echocardiography plus cardiac axis detection for detecting fetal congenital heart disease was 91.4%. The difference was significant (P <0.05). Among 518 high-risk fetuses with CHD, 34 cases of CHD were correctly diagnosed by prenatal ultrasound, 1 was false-positive and 1 was false-negative. Conclusion Normal fetal cardiac axis range from 20 to 75 degrees, such as cardiac axis> 75 degrees, should be highly suspected fetal congenital heart disease; determination of cardiac axis plays an important role in fetal congenital heart disease screening, can be used as a routine measurement.