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时间:2020-05-14
《静脉导管多普勒血流检测诊断胎儿先天性心脏病的价值.pdf》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、HainanMedJ,Ju1.2015,Vo1.26,No.13海南医学2015年7月第26卷第13期doi:10.3969/j.issn.1003—6350.2015.13.0695静脉导管多普勒血流检测诊断胎儿先天性心脏病的价值艾先梅,陈晓园,邓享雄,杨洪伟,陈莉莉(中山市古镇人民医院功能科,广东中山528421)【摘要】目的探讨静脉导管多普勒血流检测对诊断胎儿先天性心脏病的临床价值。方法对本院2010年9月至2014年8月接诊的3600例孕11-14周的单胎孕妇行静脉导管血流频谱(Dv)及颈项透明层T)检测,行超声心动图检查所有NT增厚及DV异常的胎儿,行超声心动图系统筛查孕18~
2、20周和中孕期的胎儿,系统筛查所有NT及DV正常的孕22—24周胎儿,并进一步行超声心动图检查疑为先天性心脏病(CHD)的胎儿,对所有胎Jk(出生后1周内)行超声心动图检查,引产者进行尸解,对数据进行评价。结果3600例胎儿中,与NT正常的胎儿比较,NT增厚胎儿的先天性心脏病发生率显著升高(尸l3、心脏病发生率显著升高(P<0.01),阳性预测值为62.00%、敏感性为46.27%、特异性为99.84%。结论胎儿静脉导管多普勒血流检测对胎儿先天性心脏病的诊断有较高的特异度和灵敏度,可对胎儿先天性心脏病做出有效的产前诊断,值得在临床上推广。【关键词】先天性心脏病;静脉导管;颈项透明层【中图分类号】R714.55【文献标识码】A【文章编号】1o03—6350(2015)13~1929—03ValueofDopplerflowwaveformofdutcusvenosusinearlyscreeningoffetalcongelfitalheartdefects.AIXian-mei,C4、HENXiao-yuan,DENGXiang-x~ng,YANGHong-wei,CHENLi-li.DepartmentofFunction,ZhongshanGuzhenPeopleHospital,Zhongshan528421,Guangdong,CHINA【Abstract】ObjectiveToinvestigatetheclinicalvalueofDopplerflowwaveformofdutcusvenosusinearlyscreeningoffetalcongenitalheartdisease(CAD).MethodsAtotalof3600pregnantwo5、manwithsinglefetusof11~14weeks’gestationinoilyhospitalfromSeptember2010toAugust2014receivedductusvenosus(DV)flowspec—trumandnuchaltranslucency(NT).EchocardiographywasusedtotestallthefetuseswithNTthickeningandDVab—norm@,whichwasalsoappliedtotestthefetusesat18-20weeks’gestationandduringthesecondtri6、mesterofpreg—nancy,allthefetusesof22-24weeks’gestationwithnormalNTandDaswellasthefetusessuspectedofCHD.Oneweekafterbirth,allthefetusesreceivedechocardiographyexaminationandthosewithabortionsuferedautopsy.Thedatawascollectedandstatisticallyanalyzed.ResultsComparedwiththefetuseswithnormalNT,thefetu7、seswithNTthickeninghadsignificantlyhigherincidenceofCHD(尸l<0.01),withthepositivepredictivevalueof32.73%,thesensitivityof53.73%,andthespecificityof98.87%.ComparedwithfetuseswithnormalDthefetuseswithDVab-normityhadsignif
3、心脏病发生率显著升高(P<0.01),阳性预测值为62.00%、敏感性为46.27%、特异性为99.84%。结论胎儿静脉导管多普勒血流检测对胎儿先天性心脏病的诊断有较高的特异度和灵敏度,可对胎儿先天性心脏病做出有效的产前诊断,值得在临床上推广。【关键词】先天性心脏病;静脉导管;颈项透明层【中图分类号】R714.55【文献标识码】A【文章编号】1o03—6350(2015)13~1929—03ValueofDopplerflowwaveformofdutcusvenosusinearlyscreeningoffetalcongelfitalheartdefects.AIXian-mei,C
4、HENXiao-yuan,DENGXiang-x~ng,YANGHong-wei,CHENLi-li.DepartmentofFunction,ZhongshanGuzhenPeopleHospital,Zhongshan528421,Guangdong,CHINA【Abstract】ObjectiveToinvestigatetheclinicalvalueofDopplerflowwaveformofdutcusvenosusinearlyscreeningoffetalcongenitalheartdisease(CAD).MethodsAtotalof3600pregnantwo
5、manwithsinglefetusof11~14weeks’gestationinoilyhospitalfromSeptember2010toAugust2014receivedductusvenosus(DV)flowspec—trumandnuchaltranslucency(NT).EchocardiographywasusedtotestallthefetuseswithNTthickeningandDVab—norm@,whichwasalsoappliedtotestthefetusesat18-20weeks’gestationandduringthesecondtri
6、mesterofpreg—nancy,allthefetusesof22-24weeks’gestationwithnormalNTandDaswellasthefetusessuspectedofCHD.Oneweekafterbirth,allthefetusesreceivedechocardiographyexaminationandthosewithabortionsuferedautopsy.Thedatawascollectedandstatisticallyanalyzed.ResultsComparedwiththefetuseswithnormalNT,thefetu
7、seswithNTthickeninghadsignificantlyhigherincidenceofCHD(尸l<0.01),withthepositivepredictivevalueof32.73%,thesensitivityof53.73%,andthespecificityof98.87%.ComparedwithfetuseswithnormalDthefetuseswithDVab-normityhadsignif
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