胎儿心力衰竭的准确评估及治疗

摘要

胎儿超声心动图能准确评价胎儿心脏解剖结构及宫内心血管系统临床表现,使胎儿心血管疾病产前诊断、胎儿心功能状况评估得以实现.胎儿心血管整体评分(CVPS)、心室Tei指数、脐动脉阻力指数(UARI)、搏动指数(PI)、收缩期最高血流速度与舒张期最低血流速度的比值(S/D)等逐渐成为胎儿心力衰竭程度及预后判断的主流评价指标.经胎盘转运地高辛治疗部分心力衰竭胎儿的临床应用明显改善了患胎预后.该文重点介绍胎儿心力衰竭的有效评估方法及治疗进展.%Fetal echocardiography has progressed to be able to diagnose many forms of congenital heart disease and to assess the prognosis of cardiac lesions based on their anatomy and presentation in utero. Cardiovascular profile score (CVPS), Tei-index, umbilical artery resistance index (UARI), pulsatility index (PI) and systolic-diastolic ratio (S/D) have been the leading parameters for evaluation the severity and prognosis of fetal heart failures. Transplacenta digoxin therpy has improved the outcome in part of fetal heart failure cases. This article lists straightforward methods for the rapid evaluation of the fetus wno may have congestive heart failure, and outlines the therapeutic progress of fetal heart failure and hydrops fetalis.