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目的探讨产前超声筛查诊断模式改变对胎儿心血管畸形筛查的影响。方法回顾性分析2010-2015年不同超声筛查模式下进行系统超声检查的108 443人的超声检查资料。结果 2010年1月-2015年12月检出胎儿畸形总数3401例,检出率313.62/万,其中心血管畸形的检出率最高,共检出748例,检出率为98.98/万。2013-2015年系统超声对心血管畸形检出率要明显高于2010-2012年;主要心血管畸形室间隔缺损、主动脉及其分支异常、右室双出口、法乐四联征检出率均明显高于2010-2012年。2010-2012年漏诊心血管畸形11例,漏诊率15.49%,2013-2015年漏诊心血管畸形7例,漏诊率3.35%,2013-2015年心脏畸形的漏诊率明显低于2010-2012年,差异有显著统计学意义(P<0.001)。结论产前系统超声联合胎儿超声心动图进行胎儿畸形筛查能显著提高胎儿心血管畸形的筛查率和筛查类型,值得推广。
Objective To investigate the effect of prenatal ultrasound screening on the screening of fetal cardiovascular malformations. Methods We retrospectively analyzed the data of 108 443 ultrasonographers who performed systematic ultrasonography under different ultrasound screening modalities during 2010-2015. Results A total of 3401 cases of fetal malformations were detected from January 2010 to December 2015, with a detection rate of 313.62 / million. The highest detection rate of cardiovascular malformations was found in 748 cases, with a detection rate of 98.98 / million. 2013-2015 system ultrasound detection rate of cardiovascular malformations were significantly higher than in 2010-2012; major cardiovascular malformation ventricular septal defect, abnormal aortic and its branches, right ventricular double outlet, tetralogy of Fallot detection rate Were significantly higher than in 2010-2012. 11 cases of misdiagnosis of cardiovascular malformations between 2010 and 2012, the rate of misdiagnosis was 15.49%; 7 cases of misdiagnosis of cardiovascular malformations in 2013-2015, the rate of misdiagnosis was 3.35%; the misdiagnosis rate of heart malformations in 2013-2015 was significantly lower than that of 2010-2012 There was significant statistical significance (P <0.001). Conclusion Prenatal ultrasound combined with fetal echocardiography fetal abnormality screening can significantly improve fetal screening rate and screening of cardiovascular malformations, it is worth promoting.