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目的对比分析肺静脉畸形引流(APVC)胎儿与正常胎儿心房大小的不同,探讨胎儿期心房大小改变对APVC的诊断价值。方法对81例孕期经超声检查诊断为APVC的胎儿心脏特点进行总结,建立1 500例正常胎儿心房左右径z-score模型,比较两组心房大小的差异。结果 81例APVC中完全型68例,部分型13例;正常胎儿与APVC胎儿左房(LA)z-score差异有统计学意义(P<0.05),TAPVC胎儿LA z-score均值明显小于正常胎儿(P<0.001),TAPVC胎儿中61.82%LA z-score<-2,PAPVC胎儿中41.67%LA z-score<-2,与正常组相比差异具有统计学意义(P<0.001)。结论胎儿心房大小的特征性改变是诊断APVC的重要指标之一,特别是LA z-score<-2时对诊断TAPVC具有较大的参考价值。
OBJECTIVE: To compare the differences of atrial size between APVC fetuses and normal fetuses and explore the value of fetal atrial size changes in the diagnosis of APVC. Methods The characteristics of fetus heart diagnosed by APVC in 81 pregnant women during pregnancy were summarized. A z-score model of left atrium and atrium of 1 500 normal fetuses was established, and the difference in atrial size between the two groups was compared. Results There were 68 cases of complete type and 13 partial models in 81 cases of APVC. The z-score of left atrium (LA) of normal fetuses and APVC fetuses was significantly different (P <0.05), and the average LA z-score of TAPVC fetuses was significantly lower than that of normal fetuses (P <0.001), 61.82% LA z-score <-2 in TAPVC fetus, and 41.67% LA z-score <-2 in PAPVC fetus. The difference was statistically significant compared with the normal group (P <0.001). Conclusions The characteristic changes of fetal atrial size are one of the important indexes in diagnosing APVC. Especially when LA z-score <-2, it is of great value to diagnose TAPVC.