论文部分内容阅读
目的探讨产前超声对中晚期胎儿先心病的筛查技巧和诊断价值,分析漏误诊原因,提高此类畸形的检出率,减少漏误诊。方法应用高清晰彩色多普勒超声诊断仪,对孕20～40周胎儿采用六切面法进行常规产前超声心动图检查,对疑有复杂心脏畸形者加做大动脉短轴切面、三血管切面及三血管气管切面扫查,观察内部血流的彩色多普勒及频谱多普勒情况,并与尸解和产后超声随访对照。结果产前共筛查出胎儿先天性心脏病78例,其中包括心脏位置异常、心内结构异常、心脏大血管畸形及心脏肿瘤等。产前超声筛查漏误诊先天性心脏病6例,包括部分性肺静脉异位引流2例,完全性大动脉转位不伴室间隔缺损及肺动脉狭窄2例,轻型法四2例。另有3例产前筛查发现室间隔缺损,产后超声随访闭合。结论产前超声应用常规六切面法加大动脉短轴切面、三血管切面及三血管气管切面扫查,可检出绝大部分中晚期胎儿先天性心脏病;分阶段动态产前超声检查可减少某些渐进性先天性心脏畸形的漏诊。
Objective To investigate the screening techniques and diagnostic value of prenatal ultrasound in the diagnosis of advanced fetal congenital heart disease (CHD), analyze the causes of misdiagnosis, improve the detection rate of such malformations, and reduce the misdiagnosis of missed or missed diagnosis. Methods Using high-resolution color Doppler ultrasound diagnostic apparatus, prenatal echocardiography was performed by six-section method in fetus between 20 and 40 weeks of gestation. The short-axis view of the aorta, Three-vessel tracheal section scanning, observing the internal color Doppler flow and spectral Doppler, and autopsy and postpartum ultrasound follow-up control. Results Prenatal screening of 78 cases of fetal congenital heart disease, including abnormal cardiac position, cardiac structural abnormalities, cardiac malformations and heart tumors. Prenatal ultrasound screening misdiagnosed congenital heart disease in 6 cases, including partial anomalous pulmonary venous drainage in 2 cases, complete aortic transposition without ventricular septal defect and pulmonary stenosis in 2 cases, 4 cases of light method. Another three prenatal screening found ventricular septal defect, postpartum ultrasound closed follow-up. Conclusion Prenatal ultrasound routine routine six-slice method to increase arterial short axis view, three-vessel section and three-vessel tracheal section scan can detect most of the advanced fetal heart disease; dynamic prenatal ultrasound can reduce some Misdiagnosis of progressive congenital heart defects.