超声心脏轴测定在筛查胎儿先天性心脏病中的临床意义-论文.pdf

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1、J实用临床医药季志2014年第18@Ig13期·66·ournalofC1inicalMedicineinPractice一。⋯’⋯超声心脏轴测定在筛查胎儿先天性心脏病中的临床意义王焕侠(广东医学院附属中山医院中山市陈星海医院超声科，广东中山，528415)摘要：目的探讨超声心动图测定在胎儿先天性心脏病产前超声诊断中的临床效果。方法采用IA3GIQ7超声诊断仪检查528例先心病高危胎儿，在心脏超声四腔观基础上测定胎儿心脏轴，并从多切面观察胎儿心内结构，以确定胎儿有无先心病。结果在528例先心病高危胎儿中，单纯四腔观检测有先天性心脏病胎儿29例，正常胎儿499例；而

2、心脏超声四腔观加心脏轴测定共检测有先天性心脏病胎儿43例，正常胎儿485例，差异有统计学意义(P<0．01)。经过引产儿尸体解剖、新生儿超声检查以及随访手术结果确诊后，确诊胎儿先天性心脏病者46例，单纯四腔观检测胎儿先心病的敏感性为63．04％(29／46)，应用心脏超声四腔观加心脏轴测定检测胎儿先心病的敏感性为93．48％(43／46)，差异有统计学意义(P<0．05)。结论应用超声心脏轴测定在筛选胎儿先天性心脏病中可操作性强，且具有十分重要的lf缶床意义。关键词：超声心动图；心脏缺损；先心病；产前诊断中图分类号：R725．4文献标志码：A文章编号：1672—2

3、353(2014)13—066-03DOI：10．7619dcmp．201413021ClinicalsignificanceofcardiacaxisdeterminationinthediagnosisoffetalcongenitalheartdiseaseⅥ，ANGHuanxia(DepartmentofUltrasonography，ZhongshanHospimlAffil~tedtoGz~ngdongMedicalUniversity，ChenXinghaiHospitalofZhongshan，Zhongshan，Guangdong，528415)

4、ABSIRACT：objectiveToinvestigatetheclinicalsignificanceofcardiacaxisdeterminedbyechocardiographyinthediagnosisoffetalcongenitalheartdisease(CHD)．Methods528highriskfetusesforCHDwereexaminedbyechocardiography．Cardiacaxiswasmeasuredonfourchamberviewandfetalcardicanatomicalstructurewasexam

5、inedinmultipleviewstodetermineCHD．Re．suits29casesoffetalcongenitalheartdiseaseand499casesofnormalfetusweredetectedbyfourchamberviewin528casesofcongenitalheartdiseaseriskinthefetuspure．However．43casesoffetalcongenitalheartdiseaseand485casesofnormalfetusweredetectedbycombinationoffourCh

6、amberviewandcardiacaxisdeterminationin528casesofcongenitalheartdiseaseriskinthefetuspure(P<0．01)．Finally，46casesoffetalcongenitalheartdiseaswerediagnosedthroughperinatalautopsy，newbornultrasoundexaminationortheresultsafterdiagnosis．SensitivityofCHDdiag—nosedbyfourchamberviewalonewas63

7、．04％．However，itwaselevatedto93．48％bycombina—lionoffourChamberviewandcardiacaxisdetermination(P<0．05)．ConclusionCardiacaxisplaysakeyroleinfetalechocardiographicscreeningforCHD．KEYⅥ：echocardiography；heartdefects；congenital；prenataldiagnosis先天性心脏病简称先心病，是d,JL中最为常测，可有效提高胎儿先天性心脏病的产前诊断率，见的一种

8、先天性疾病