陈晓斌

[摘要] 目的 探讨采用彩色多普勒超声诊断胎儿心脏畸形的临床价值，为临床提供可參考依据。 方法 对2017年1月—2018年2月2 120例胎儿行超声心动图检查，检查内容有四腔心切面、右心室流出道切面、左心室流出刀切面、主动脉弓及导管弓切面、三血管切面及上下腔静脉长轴切面，同时观察有无先天性心脏畸形。 结果 经彩色多普勒超声检测出33例胎儿心脏畸形，漏诊3例。33例胎儿心脏畸形中，其中5例完全性心内膜垫缺损、4例主动脉弓离断或缩窄、3例单心房、2例单心室、2例永存动脉干、3例大动脉转位、1例右室双出口、3例单纯室间隔缺损、2例法洛四联症、1例肺动脉狭窄或闭锁、5例三尖瓣下移、2例其他畸形，漏诊3例室间隔小缺损，均通过新生儿超声心动图检查及引产后证实。 结论 采用彩色多谱勒超声诊断胎儿心脏畸形具有很高的临床价值，准确率高，无创伤，安全性高，可作为诊断胎儿畸形的首选方法，值得临床推广应用。

[关键词] 彩色多普勒超声；胎儿；心脏畸形

[中图分类号] R445.1；R714.5 [文献标识码] A [文章编号] 1674-0742（2018）10（c）-0182-03

[Abstract] Objective To investigate the clinical value of color Doppler ultrasound in the diagnosis of fetal heart malformation， and to provide reference for clinical. Methods From January 2017 to February 2018， 2 120 fetuses underwent echocardiography. The examination included four-chamber view， right ventricular outflow tract， left ventricular outflow， aortic arch and ductal cut， three-vessel cut and the long axis of the superior and inferior vena cava was observed while observing the presence or absence of congenital heart malformation. Results 33 cases of fetal heart malformation were detected by color Doppler ultrasound， and 3 cases were missed. Of the 33 cases of fetal heart malformation， 5 were complete endocardial pad defects， 4 cases had aortic arch dissection or constriction， 3 cases had single atrium， 2 cases had single ventricle， 2 cases had permanent arterial trunk， 3 cases had aortic transposition， 1 case of right ventricular double exit， 3 cases of simple ventricular septal defect， 2 cases of tetralogy of fallot， 1 case of pulmonary stenosis or atresia， 5 cases of tricuspid valvular movement， 2 cases of other malformations， and 3 cases of ventricular septal defect. Confirmed by neonatal echocardiography and after induction of labor. Conclusion Color Doppler ultrasound diagnosis of fetal heart malformation has high clinical value， high accuracy， no trauma， high safety， and can be used as the first choice for diagnosis of fetal malformation. It is worthy of clinical application.

[Key words] Color Doppler ultrasound； Fetal； Cardiac malformation

我国每年出生的新生儿中，先天性心脏病患儿占8‰～11‰，居新生儿缺陷疾病首位[1]。随着超声诊断技术的不断发展，彩色多普勒技术在临床上得到广泛应用，在超声下胎儿的心血管结构能清晰的显示，并能对产前胎儿心脏结构异常做出诊断。彩色多普勒超声能诊断出大多数严重的胎儿心脏畸形，可减少围生期死亡率[2]。所以对妊娠期孕妇进行心脏检查，可尽早的检查出胎儿心脏畸形，并及时做出应对措施。……