产前超声筛查胎儿心脏畸形结果分析

张艳红　吴绍宇　遇建东

摘 要：目的 探討胎儿心脏畸形超声系统检查检出率、超声检查最佳时机及漏诊情况。方法 2013年1月～2016年8月51290例孕早、中、晚期孕妇，依据中国医师协会《产前超声检查指南（2012）》标准与要求进行筛查胎儿心脏畸形。结果 超声产前检出胎儿心脏畸形263例，检出率为5.13‰，各年间胎儿心脏畸形检出率比较，差异无统计学意义（P>0.05）。孕早期、中期、晚期胎儿心脏畸形检出率分别为1.25‰、7.71‰、5.13‰，三个孕周间胎儿心脏畸形检出率比较，差异有统计学意义（P<0.05）；孕早期胎儿心脏畸形检出率与孕中期比较，孕晚期胎儿心脏畸形检出率与孕中期比较，孕早期胎儿心脏畸形检出率与孕晚期比较，差异有统计学意义（P<0.05）。超声产前漏诊9例，漏诊率为3.31%。结论 近年佳木斯市胎儿心脏畸形发病率处于稳定，略有上升的趋势，胎儿心脏畸形的最佳检查时间为孕中期。

关键词：胎儿心脏畸形；产前超声筛查；不同孕期

中图分类号：R714.53 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.10.055

文章编号：1006-1959（2018）10-0161-03

Analysis of Results of Prenatal Ultrasound Screening for Fetal Cardiac Malformation

ZHANG Yan-hong，WU Shao-yu，YU Jian-dong

（Department of Physical Diagnosis，Jiamusi Maternal and Child Health Planning and Childbirth Service Center，Jiamusi 154003，Heilongjiang，China）

Abstract：Objective To investigate the detection rate of fetal heart malformation by ultrasonic system，the best time of ultrasonic examination and the condition of missed diagnosis.Methods From January 2013 to August 2016，51290 pregnant women with early， middle and late pregnancy were screened for fetal heart malformations，according to the Chinese Medical Association"Prenatal Ultrasound Examination Guidelines（2012）"standards and requirements for screening for fetal heart malformations.Results There were 263 cases of fetal cardiac abnormalities detected before ultrasound.The detection rate was 5.13 ‰，there was no statistically significant difference in the detection rate of fetal cardiac abnormalities in each year（P>0.05）.The detection rates of cardiac malformation in early， middle and late pregnancy were 1.25 ‰，7.71‰and 5.13 ‰，respectively，the difference of fetal heart malformation rate in three gestational weeks was statistically significant（P<0.05）；The detection rate of fetal heart malformation in the early pregnancy was compared with that in the middle pregnancy.The rate of fetal cardiac malformation in the late pregnancy was compared with that in the middle pregnancy.The rate of fetal cardiac malformation in the early pregnancy was compared with that in the late trimester，and the difference was statistically significant（P<0.05）.9 cases were missed by ultrasound，and the rate of missed diagnosis was 3.31%. Conclusion In recent years，the incidence of fetal heart malformation in Jiamusi city has been stable，with a slight increase.The best check time for fetal heart malformation is in the second trimester.

Key words：Fetal cardiac malformation；Prenatal ultrasound screening；Different pregnancy

先天性心脏病（congenital heart disease）是一种较为严重的胎儿先天性畸形，其发病率已上升到出生缺陷第1位[1]，其是新生儿死亡的主要原因之一，其严重影响危害人类的生存质量和健康，及早诊断、及时终止妊娠，对减少畸形儿的出生及降低围产儿死亡率具有重要意义。产前系统超声是目前诊断胎儿心脏畸形有效、安全的首选及常用方法[2]。选取该院2013年1月～2016年8月超声系统筛查孕妇51290例，现将胎儿心脏畸形检出情况，分析如下。

1资料与方法

1.1一般资料 选取2013年1月1日～2016年8月31日在佳木斯市妇幼保健计划生育服务中心产前超声筛查的孕妇51290例为研究对象，年龄20～42岁，平均年龄（28.58±9.21）岁；其中孕早期（11～13+6周）孕妇16846例，孕中期（20～24周）孕妇25285例，孕晚期（28～32周）孕妇9159例。

1.2方法 胎儿产前超声筛查依据中国医师协会《产前超声检查指南（2012）》标准与要求进行筛查胎儿心脏畸形。检查前，所有孕妇需阅读并签署《产前超声检查知情同意书》，护理人员负责解释并介绍。根……