【摘要】
目的 探讨彩色多普勒超声心动图对胎儿先天性心脏畸形诊断的临床价值。方法 对彩
色多普勒超声心动图对
25 例胎儿心脏进行产前、产后检查分析，运用先心病的三节段分析
法及胎儿腹部横切面、四腔心切面、左右心室流出道切面、大动脉短轴切面、主动脉弓长轴切
面、动脉导管切面和上下腔静脉切面探查胎儿心脏，并对心脏结构及血流分布进行观察。结
果
超声心动图对 25 例胎儿心脏异常孕妇进行检查，产前检出心脏畸形 13 例,正常 12 例；
产后复查心脏畸形
12 例，正常 11 例，诊断符合率为 92%(23/25),漏、误诊 2 例，漏、误诊率
为
8%(2/25)。结论 彩色多普勒超声心动图能够在产前对胎儿先天性心脏畸形做出正确诊断。
【关键词】
胎儿心脏；彩色多普勒超声心动图；先天性心脏畸形
Prenatal Doppler Echocardiography diagnosis of congenital heart malformation
LI Jun-ren, QIE Zhan-jun, JIA Mei, et al.
(The Affiliated Hospital of Ningxia Medical University, Yinchuan 750004, China)
［
Abstract］ Objective To discuss the clinical value of the Doppler echocardiography for
detecting fetal congenital heart malformation.Methords 25cases of hearts were examined before
and after delivery. The 3-step-analysis method was carried out in fetal abdomen transverse section,
4-chamber section, left-right outflow tract, big atrial short-axis section, long axis section of the
aortic arch and long axis section of inferior-outferior vena cava to observe the anatomical
structures of heart and the characteristics of blood flow.Results 25 fetuses with doubtful heart
diseases were examined. 13 cases were diagnosed with heart diseases, 12 ones were diagnosed to
be normal before delivery. 12cases had heart diseases and 11ones were normal after delivery. The
diagnostic concordant rate was 92% (23/25). 2 cases were misdiagnosed or failed to be diagnosed,
the missed rate was 8% (2/25).Conclusion the Doppler echocardiography can make right
diagnosis to congenital heart diseases of fetuses.
［Key words］ Fetal heart; Doppler echocardiography; congenital heart malformation
先天性心脏病的发病率为活产婴儿的
7
‰-8‰［1］ ，我国每年约有 15 万新生儿患各
类先天性心脏病
,严重影响儿童的生命健康和人口质量。本研究总结了我院自 2007-2009 年以
来经超声心动图诊断的
25 例胎儿结果现分析如下。
1 材料和方法
1.1 研究对象：选择 2007-2009 年对经常规胎儿超声筛查心脏异常的 25 名孕妇进行胎
儿超声心动图检查，孕期
27-35 周,平均 33 周。年龄 23-38 岁，平均 28 岁。
1.2 方法: 采用美国 Vivid7 彩色多普勒超声诊断仪,探头频率 3-5MHz，选用胎儿心脏显
像模式。孕妇取平卧位或者侧卧位
,首先行常规胎儿超声检查，再对胎儿心脏进行胎儿腹部
横切面、四腔心切面、左右心室流出道切面、大动脉短轴切面、主动脉弓长轴切面、动脉导管切
面和上下腔静脉切面等多切面检查
,对胎儿心脏复杂畸形辅以其它非标准切面检查，并在产
后进行追踪复查。