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目的探讨不同类型胎儿心律失常的围产期处理及结局。方法回顾性分析2003年10月~2010年12月在深圳市妇幼保健院经超声心动图筛查诊断为胎儿心律失常的病例。结果共筛查胎儿心律失常130例,其中期前收缩59例、窦性心动过缓23例、窦性心动过速16例、房室传导阻滞12例、房颤3例、其他心律失常17例。其中12例(9.2%)合并先天性心血管畸形,胎儿心动过缓多见。心律失常不同分类之间的预后有显著性差异(P=0.000)。心律失常分类(P=0.024)、合并先天性心脏病(P=0.000)及胎儿水肿(P=0.008)是胎儿预后不良的危险因素。结论大部分阵发性心律失常胎儿在严密监护保守治疗下,胎儿预后良好,胎儿心动过缓预后较差。胎儿心律失常围生期预后与胎儿心律失常分类、是否伴有心血管或其他畸形、有无胎儿水肿密切相关。
Objective To investigate perinatal treatment and outcome of different types of fetal arrhythmias. Methods Retrospective analysis of cases of fetal arrhythmia diagnosed by echocardiography screening in Shenzhen Maternal and Child Health Hospital from October 2003 to December 2010. Results A total of 130 cases of fetal arrhythmia were screened. Among them, there were 59 cases of pretermannular contraction, 23 cases of sinus bradycardia, 16 cases of sinus tachycardia, 12 cases of atrioventricular block, 3 cases of atrial fibrillation and other arrhythmias example. 12 cases (9.2%) with congenital cardiovascular malformations, fetal bradycardia more common. There was a significant difference in the prognosis between different categories of arrhythmia (P = 0.000). Arrhythmia classification (P = 0.024), combined congenital heart disease (P = 0.000), and fetal edema (P = 0.008) were risk factors for poor fetal outcomes. Conclusion Most of paroxysmal arrhythmia fetus under the care of intensive care, the fetus has a good prognosis, poor prognosis of fetal bradycardia. Fetal arrhythmia perinatal prognosis and fetal arrhythmia classification, whether associated with cardiovascular or other deformities, with or without fetal edema are closely related.