多普勒超声在中孕期胎儿复杂先天性心脏畸形中的筛查应用及胎儿心功能分析

摘要

Objective To investigate the effect of Doppler ultrasound in the screening of trimester fetal complex congenital heart malformation and in the analysis of fetal cardiac function.Methods 6 000 trimester pregnant women taking ultrasound examination at our hospital from August,2014 to January,2016 were selected as study objects.Doppler ultrasound was used to scan the fetuses' hearts to screen fetal congenital heart disease and the results were compared with the follow-up results.The value of Doppler ultrasound in the screening of congenital heart malformation was analyzed.The fetuses screened with congenital heart disease by ultrasound were set as a study group.And 50 fetuses of normal pregnancy were set as a control group.The fetal right ventricle end-diastolic volume (EDV),end-systolic volume (ESV),stroke volume (SV),and ejection fraction (EF) were detected and compared between these two groups.Results Among the 6 000 women,45 were diagnosed with fetuses with complex congenital cardiac malformations by follow-up,and the incidence was 0.75％.42 cases were screened with complex congenital cardiac malformations by Doppler ultrasound,and the screening rate was 0.70％.Its diagnostic sensitivity was 88.89％ and its specificity was 99.97％.The complex congenital heart malformation types diagnosed by Doppler ultrasound were coincident with the follow-up results,with no statistical differences (P＜0.05).The values of EVD,SV,and EF were lower in the study group than in the control group [(1.96 ± 0.64) ml vs.(2.28 ± 0.54) ml,(1.20 ± 0.49) ml vs.(1.59 ± 0.61) ml,and (60.21 ± 6.14) ％ vs.(67.83 ± 6.21)％,P＜0.05].Conclusions Doppler ultrasound in screening of trimester fetal complex congenital heart malformation has high sensitivity and specificity and can effectively diagnose malformations types.The cardiac function of fetuses with complex congenital cardiac malformations significantly reduces.%目的 探讨多普勒超声在中孕期胎儿复杂先天性心脏畸形中的筛查效果并分析胎儿右心室心功能.方法 选取2014年8月至2016年1月本院超声科检查6 000名中孕期孕妇为研究对象,采用多普勒超声对胎儿心脏进行扫描,筛查出胎儿先天性心脏畸形患儿,与随访结果进行对比,分析多普勒超声在先天性心脏畸形筛查中的价值,将超声筛查出先天性心脏病胎儿作为研究组,选取正常妊娠胎儿50名作为对照组,分别检测并比较两组胎儿右心室舒张末期容积(EDV)、收缩末期容积(ESV)、每博量(SV)及射血分数(EF).结果 6 000名中孕期孕妇通过随访明确诊断为复杂先天性心脏畸形胎儿45例,发病率为0.75％.经多普勒超声筛查出42例,筛查率为0.70％.其诊断灵敏度为88.89％,特异性为99.97％.多普勒超声在复杂先天性心脏畸形类型中诊断与随访结果基本一直,差异无统计学意义(P＜0.05).研究组EVD、SV、EF值均低于对照组[(1.96:0.64) ml vs.(2.28±0.54) ml,(1.20±0.49)ml vs.(1.59±0.61) ml,(60.21±6.14)％vs.(67.83±6.21)％,P＜0.05].结论 多普勒超声在中孕期复杂先天性心脏畸形筛查中具有较高灵敏度和特异性,能有效诊断出畸形类型.复杂先天性心脏畸形胎儿心功能水平显著降低.