宁夏地区先天性心脏病患儿发病情况与孕妇孕中期超声检查的相关性研究

田国林　赵芳　　聂黎红　　赵瑞宁

[摘要] 目的 探討宁夏地区先天性心脏病（CHD）发病情况与孕妇孕中期超声检查的相关性。 方法 选取 2015年10月至2018年10月宁夏医科大学总医院收住的年龄在0～14周岁经心脏超声和（或）手术确诊的 CHD 患儿为研究对象，进行回顾性分析;通过电话/短信等方式咨询孕妇孕中期超声检查资料。 结果 孕妇孕中期 CHD 超声检查的孕检率为90.822%，检出率为13.780%，检出准确率为66.667%;宁夏地区三级医院的 CHD 超声筛查检出率高于二级和其他医院（P<0.05）;动脉导管未闭、房间隔缺损、室间隔缺损和肺动脉高压是患儿主要的 CHD 病理类型;而患儿单一类型CHD与两种及以上CHD的发病率基本一致。 结论 宁夏地区各级医院孕妇孕中期CHD 超声筛查水平与国内先进水平还有一定的距离，且其具有明显的医院级别差异性，应大力加强基层医疗机构孕妇孕中期 CHD 的筛查水平。

[关键词] 先天性心脏病;孕中期;超声;儿童

[中图分类号] R726.5          [文献标识码] B          [文章编号] 1673-9701（2021）12-0116-03

Research on the correlation between incidence of congenital heart disease and ultrasound examination in the second trimester of pregnancy in Ningxia

TIAN Guolin1   ZHAO Fang2   NIE Lihong3   ZHAO Ruining1

1.School of Clinical Medicine， Ningxia Medical University， Yinchuan   750004， China; 2.Department of Pediatrics， General Hospital of Ningxia Medical University， Yinchuan   750004， China; 3.Department of Physiology， School of Basic Medicine， Ningxia Medical University， Yinchuan   750004， China

[Abstract] Objective To investigate the correlation between the incidence of congenital heart disease（CHD） and ultrasound examination in the second trimester of pregnancy in Ningxia. Methods The CHD children aged 0-14 years old who were admitted to the General Hospital of Ningxia Medical University from October 2015 to October 2018 and confirmed by cardiac ultrasound and/or surgery were selected as the research objects for retrospective analysis. The ultrasound examination data of the pregnant women in the second trimester of pregnancy were obtained by telephone/short message， etc. Results The pregnancy detection rate of CHD ultrasound examination in the second trimester of pregnancy was 90.822%， the detection rate was 13.780%， and the detection accuracy rate was 66.667%. The detection rate of CHD was higher in tertiary hospitals in Ningxia than that in secondary hospitals and other hospitals（P<0.05）. Patent ductus arteriosus， atrial septal defect， ventricular septal defect and pulmonary hypertension were the main pathological types of CHD in children. However， the incidence of single type of CHD in children was basically the same as that of two or more types of CHD. Conclusion There is still a certain gap between the ultrasonic screening level of pregnant women in the second trimester of pregnancy in hospitals at all levels in Ningxia and the advanced level in China， and there are obvious differences in hospital levels. Therefore， the screening level of pregnant women in the second trimester of pregnancy in primary medical institutions should be greatly strengthened.

[Key words] Congenital heart disease; The second trimester of pregnancy; Ultrasound; Children

先天性心脏病（Congenital heart disease，CHD）是威胁我国儿童健康的主要疾病之一，孕中期胎儿心脏超声检查则是筛查CHD最主要的检查方式，临床工作表明超声筛查具有相对较高的诊断效能，可作为常规检查的补充诊断方案，可更加直观、立体地显示胎儿心脏结构，降低漏诊率及误诊率[1]，而孕中期孕妇是否实施胎儿心脏超声检查及孕妇产检医院的超声检查水平直接影响着胎儿CHD的检出。本项目通过回顾性调查2015年10月至2018年10月入住宁夏医科大学总医院的CHD患儿临床资料、孕妇孕中期产检超声资料，分析两者相关性，旨在为宁夏各级医院普及孕中期超声检查、加强基层医院胎儿超声医生培训、孕妇规律产检宣教工作提供理论依据与数据资料，同时积极发挥区内优势医疗资源的作用，以期提高我区孕妇孕中期CHD筛查的质量并降低我区CHD的发生率。

1 资料与方法

1.1 一般资料