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目的探索彩色多普勒超声心动图在胎儿先天性心血管畸形(先心病)的产前筛查和诊断中的价值。方法 1600例产检的孕妇,其中800例高危孕妇作为高危组,800例无明显高危因素的健康孕妇作为对照组,两组孕妇进行产前彩色多普勒超声心动图检查,将检测出的胎儿先心病结果与引产后病理结果或出生后结果进行对比。结果高危组产前先心病检出率为6.63%,明显高于对照组的1.88%,差异有统计学意义(P<0.05)。与病理诊断或出生后检查结果对比,高危组产前超声检出正确率为98.15%,对照组的产前超声检出正确率为88.24%,比较差异无统计学意义(P>0.05)。在先心病类型上,房间隔缺损、室间隔缺损、大血管异常发生率较高,肺动脉闭锁的发生率最低,心脏增大并腹水、三尖瓣下移、法洛氏四联症的发生率均较低。漏诊病例中心脏增大并腹水1例,法洛氏四联症2例。结论在胎儿先心病的产前筛查和诊断中,应用彩色多普勒超声心动图检查效果确切,检出正确率高,有助于临床医师早期发现胎儿心血管发育畸形,从而及时采取必要的措施进行早期干预,提高人口出生质量。
Objective To explore the value of color Doppler echocardiography in prenatal screening and diagnosis of congenital cardiovascular malformation (congenital heart disease). Methods A total of 1600 pregnant women, including 800 high-risk pregnant women, were selected as the high-risk group and 800 healthy pregnant women without obvious risk factors as the control group. The pre-pregnancy color Doppler echocardiography was used to examine the fetus Heart disease results and post-labor pathological results or postnatal results were compared. Results The detection rate of prenatal heart disease in high risk group was 6.63%, which was significantly higher than that in control group (1.88%), the difference was statistically significant (P <0.05). Compared with the results of pathological diagnosis or postnatal examination, the correct rate of prenatal ultrasound in high-risk group was 98.15%, while the positive rate of prenatal ultrasound in control group was 88.24%, with no significant difference (P> 0.05). In the type of congenital heart disease, atrial septal defect, ventricular septal defect, a large incidence of vascular abnormalities, pulmonary atresia the lowest incidence of heart enlargement and ascites, tricuspid valve down, the incidence of tetralogy of Fallot Are lower. Misdiagnosed cases of cardiac enlargement and ascites in 1 case, tetralogy of Fallot in 2 cases. Conclusion In prenatal screening and diagnosis of fetal CHD, the application of color Doppler echocardiography has the exact effect and the high correct rate, which helps clinicians to detect fetal cardiovascular malformations in the early stage and timely take the necessary Measures for early intervention to improve the quality of birth of the population.