中孕期彩色多普勒超声检测对胎儿先天性心脏病的诊断价值
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摘要
目的探讨中孕期彩色多普勒超声检测对胎儿先天性心脏病的诊断价值。方法选取2014年5月—2017年5月收治的2494例中孕期孕妇作为研究对象。所有孕妇均经常规超声以及彩色多普勒超声检查,且产后新生儿均进行超声检查,引产后胎儿均进行尸检。比较不同检查方法与产后新生儿或引产后胎儿确诊结果的差异。结果本组共确诊为胎儿先天性心脏病14例,发病率为0. 56%。常规超声对中孕期胎儿先天性心脏疾病的诊断率与确诊结果比较差异具有统计学意义(χ2=4. 279,P=0. 039)。彩色多普勒超声对中孕期胎儿先天性心脏疾病的诊断率显著高于常规超声(χ2=3. 864,P=0. 042),且与确诊结果比较差异无统计学意义(χ2=0. 037,P=0. 847)。结论彩色多普勒超声检查对中孕期胎儿先天性心脏病具有较高检出率,且具有一定的安全性和便捷性。
Objective To investigate value of color Doppler ultrasonography in diagnosis of fetal congenital heart disease in mid-gestation. Methods A total of 2494 pregnant women admitted during May 2014 and May 2017 were selected as research objects. All pregnant women received conventional examinations of ultrasound and color Doppler ultrasound,and postpartum neonates were examined by ultrasound,and the fetuses after induction of labor were given autopsy. Differences of pathological and anatomic results between different examination methods with confirmation results of postpartum neonates after induction of labor. Results In this group,14 fetuses were diagnosed as having congenital heart disease,and the incidence rate was 0. 56%. The differences in diagnosis rate by conventional ultrasonography with confirmed results in fetal congenital heart disease in mid-gestation were statistically significant(χ2= 4. 279,P = 0. 039). Diagnosis rate by color Doppler ultrasound was significantly higher than that by conventional ultrasonography in fetal congenital heart disease in mid-gestation(χ2= 3. 864,P = 0. 042),and there were no significant differences between the screening rates with confirmed results in two groups(χ2= 0. 037,P = 0. 847). Conclusion Color Doppler ultrasonography has a high detection rate in fetal congenital heart disease in mid-gestation with a certain safety and convenience.
Objective To investigate value of color Doppler ultrasonography in diagnosis of fetal congenital heart disease in mid-gestation. Methods A total of 2494 pregnant women admitted during May 2014 and May 2017 were selected as research objects. All pregnant women received conventional examinations of ultrasound and color Doppler ultrasound,and postpartum neonates were examined by ultrasound,and the fetuses after induction of labor were given autopsy. Differences of pathological and anatomic results between different examination methods with confirmation results of postpartum neonates after induction of labor. Results In this group,14 fetuses were diagnosed as having congenital heart disease,and the incidence rate was 0. 56%. The differences in diagnosis rate by conventional ultrasonography with confirmed results in fetal congenital heart disease in mid-gestation were statistically significant(χ2= 4. 279,P = 0. 039). Diagnosis rate by color Doppler ultrasound was significantly higher than that by conventional ultrasonography in fetal congenital heart disease in mid-gestation(χ2= 3. 864,P = 0. 042),and there were no significant differences between the screening rates with confirmed results in two groups(χ2= 0. 037,P = 0. 847). Conclusion Color Doppler ultrasonography has a high detection rate in fetal congenital heart disease in mid-gestation with a certain safety and convenience.
引文
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[12]董向阳,李文静,陈忠建.彩色多普勒超声在房间隔缺损介入封堵术中的应用价值[J].保健医学研究与实践,2017,14(4):49-51,55.
[13]聂聪,黎玲玲,周启昌.产前超声诊断右室双出口Taussig-Bing型并主动脉弓离断1例[J].中华超声影像学杂志,2016,25(9):823,827.
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[16]刘晓伟,满婷婷,何怡华.超声评估主动脉缩窄胎儿主动脉弓狭窄部位的血流动力学特点[J].中国医学影像技术,2017,33(2):251-254.
[17]郭素萍,周爱云.超声诊断胎儿食管闭锁合并小脑下蚓部缺损、完全性心内膜垫缺损1例[J].中国超声医学杂志,2016,32(9):829.
[18]范丽嫒.超声心动图在胎儿左心发育不良综合征诊断中的应用[J].中外女性健康研究,2016(9):71.
[19]陈秋月,吕国荣,刘云萍,等.双多普勒超声评估胎儿心律失常的应用价值[J].中华超声影像学杂志,2016,25(3):198-202.
[20]沈亲亲,张檀.宁波地区孕妇中孕期血清筛查与先天性心脏病相关性研究[J].中国预防医学杂志,2016,17(7):551-553.
[21]於铀,李琳.优质护理在小儿先天性心脏病手术中的应用体会[J].血管与腔内血管外科杂志,2017,3(4):902-904.
[22]张鑫,师晓娟,王胜利.三维超声心动图诊断胎儿先天性心脏病的临床价值[J].西南国防医药,2017,27(2):167-169.
[23] Han W,Xie M,Cheng T O,et al. The vital role the ductus arteriosus plays in the fetal diagnosis of congenital heart disease:evaluation by fetal echocardiography in combination with an innovative cardiovascular cast technology[J]. Int J Cardiol,2016,202:90-96.
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[25]吴意赟,梁定,殷立平,等.彩色多普勒超声对浆细胞性乳腺炎的诊断价值[J].解放军医药杂志,2014,26(9):82-84.
[26]陈兵勇,尹晓云,陈婕,等.超声软指标对早孕期胎儿心脏严重结构异常的意义[J].中华生物医学工程杂志,2016,22(2):150-153.
[27]陈晓媛,王安辉,苏海砾. 1009例婴幼儿先天性心脏病危险因素的病例对照研究[J].中华疾病控制杂志,2016,20(11):1114-1116.
[28] Arashiro E K N,Ungerfeld R,Clariget R P,et al. Early pregnancy diagnosis in ewes by subjective assessment of luteal vascularisation using colour Doppler ultrasonography[J]. Theriogenology,2017,106:247-252.
[29]项瓯.浙江省温州地区围生儿先天性心脏病相关因素病例对照研究[J].疾病监测,2017,32(6):504-508.
[2]周芳,赵书平,王薇,等.产前超声在中孕期胎儿严重先天性心脏病筛查中的应用[J].现代生物医学进展,2016,16(23):4533-4535.
[3]王金瑜,赵笔辉,李燕静.产前超声在胎儿先天性心脏病筛查中的临床应用价值[J].医学影像学杂志,2016,26(7):1321-1323.
[4]邢杰.探讨心脏超声筛查对胎儿先天性心脏病诊断及临床应用价值[J].中国妇幼保健,2016,31(5):986-987.
[5]孙星星,张忠磊,贺祎.产前超声筛查胎儿先天性心脏病价值和意义的探讨[J].中国优生与遗传杂志,2017,22(1):113-114.
[6]弓瑜.彩色多普勒超声检查在孕中晚期胎儿心脏畸形筛查中的临床价值[J].陕西医学杂志,2017,46(10):1449-1450.
[7]朱继红,夏辉,陈英红,等.超声检查与母体血清学联合检测筛查胎儿先天性心脏病[J].中国现代医学杂志,2017,27(13):96-98.
[8]闫景彬,闫秀梅,杨建享,等.产前超声筛查胎儿先天性心脏病的临床意义及高危因素分析[J].中华全科医学,2016,14(1):114-115,160.
[9]王锡丽,徐志富.下肢动脉狭窄闭塞性疾病影像学诊断对比研究[J].解放军医药杂志,2016,28(6):77-79.
[10] Verdurmen K M,Eijsvoogel N B,Lempersz C,et al. A systematic review of prenatal screening for congenital heart disease by fetal electrocardiography[J]. Int J Gynecol Obstet,2016,135(2):129-134.
[11]杨静,刘霞,许川一,等.四维超声STIC技术在胎儿心脏畸形辅助诊断中的应用价值[J].中华全科医学,2016,14(3):452-454.
[12]董向阳,李文静,陈忠建.彩色多普勒超声在房间隔缺损介入封堵术中的应用价值[J].保健医学研究与实践,2017,14(4):49-51,55.
[13]聂聪,黎玲玲,周启昌.产前超声诊断右室双出口Taussig-Bing型并主动脉弓离断1例[J].中华超声影像学杂志,2016,25(9):823,827.
[14]孙艳平.产前超声心动图诊断胎儿肺动脉瓣狭窄与合并心内畸形的价值探讨[J].中外女性健康研究,2015(18):217,224.
[15]陈夏夏.超声诊断小儿法洛四联症合并肺动脉闭锁1例[J].安徽卫生职业技术学院学报,2017,16(3):151-152.
[16]刘晓伟,满婷婷,何怡华.超声评估主动脉缩窄胎儿主动脉弓狭窄部位的血流动力学特点[J].中国医学影像技术,2017,33(2):251-254.
[17]郭素萍,周爱云.超声诊断胎儿食管闭锁合并小脑下蚓部缺损、完全性心内膜垫缺损1例[J].中国超声医学杂志,2016,32(9):829.
[18]范丽嫒.超声心动图在胎儿左心发育不良综合征诊断中的应用[J].中外女性健康研究,2016(9):71.
[19]陈秋月,吕国荣,刘云萍,等.双多普勒超声评估胎儿心律失常的应用价值[J].中华超声影像学杂志,2016,25(3):198-202.
[20]沈亲亲,张檀.宁波地区孕妇中孕期血清筛查与先天性心脏病相关性研究[J].中国预防医学杂志,2016,17(7):551-553.
[21]於铀,李琳.优质护理在小儿先天性心脏病手术中的应用体会[J].血管与腔内血管外科杂志,2017,3(4):902-904.
[22]张鑫,师晓娟,王胜利.三维超声心动图诊断胎儿先天性心脏病的临床价值[J].西南国防医药,2017,27(2):167-169.
[23] Han W,Xie M,Cheng T O,et al. The vital role the ductus arteriosus plays in the fetal diagnosis of congenital heart disease:evaluation by fetal echocardiography in combination with an innovative cardiovascular cast technology[J]. Int J Cardiol,2016,202:90-96.
[24]李燕娜,杨冬,张军.胎儿先天性心脏病的筛查和孕期管理[J].中国医药,2017,12(12):1768-1770.
[25]吴意赟,梁定,殷立平,等.彩色多普勒超声对浆细胞性乳腺炎的诊断价值[J].解放军医药杂志,2014,26(9):82-84.
[26]陈兵勇,尹晓云,陈婕,等.超声软指标对早孕期胎儿心脏严重结构异常的意义[J].中华生物医学工程杂志,2016,22(2):150-153.
[27]陈晓媛,王安辉,苏海砾. 1009例婴幼儿先天性心脏病危险因素的病例对照研究[J].中华疾病控制杂志,2016,20(11):1114-1116.
[28] Arashiro E K N,Ungerfeld R,Clariget R P,et al. Early pregnancy diagnosis in ewes by subjective assessment of luteal vascularisation using colour Doppler ultrasonography[J]. Theriogenology,2017,106:247-252.
[29]项瓯.浙江省温州地区围生儿先天性心脏病相关因素病例对照研究[J].疾病监测,2017,32(6):504-508.