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目的:对胎儿先天性心脏病(先心病)进行尸体解剖分析,提高该疾病诊断的精准性。方法:回顾近几年我院经超声心动图畸形筛查,发现胎儿先天性心脏畸形引产而进行尸体解剖病例,分析胎儿心血管畸形不同类型的发病情况及特点,有关心血管畸形按心脏节段分析方法进行分析观察。结果:胎儿先心病尸体解剖200例,男性93例,女性107例,孕12~38周,胎儿先天性心脏病类型:心房/心耳畸形16例,体静脉畸形45例,肺静脉畸形28例,冠状静脉窦畸形4例;房间隔畸形55例,房室瓣畸形及骑跨24例,房室间隔缺损26例,室间隔畸形87例,左心发育不良综合征17例,右心发育不良综合征9例,法洛四联症12例,心室双出口21例,大动脉转位20例,心室单出口21例,主动脉瓣畸形14例;肺动脉瓣畸形28例;主动脉近段畸形73例,肺动脉畸形26例,动脉导管畸形18例;冠状动脉畸形6例;右旋心5例。常见畸形为室间隔缺损56例(28%)、房间隔缺损36(18%)和永存左上腔静脉35(17.5%),单心室31(15.5%),主动脉弓发育不良25(12.5%),右位主动脉弓23(11.5%)。结论:胎儿先心病室间隔缺损、房间隔缺损、永存左上腔静脉、单心室及主动脉弓发育不良发病率较高;胎儿心血管畸形变异较多,血管较细小,解剖时应仔细寻找每一个分支。
Objective: To analyze the autopsy of fetal congenital heart disease (CHD) to improve the accuracy of the diagnosis of the disease. Methods: Review of our hospital in recent years by echocardiography deformity screening found fetus congenital heart malformations induced by autopsy cases, analyze the incidence of fetal cardiovascular malformations and characteristics of different types of cardiovascular malformations by the heart segment Analytical methods for analysis and observation. Results: There were 200 cases of autopsy of fetus with congenital heart disease, including 93 males, 107 females and 12 to 38 weeks of gestation. The types of fetal congenital heart disease were 16 with atrial / auricular malformation, 45 with venous malformations, 28 with pulmonary venous malformations, Sinus malformations in 4 cases, 55 cases of atrial septal deformity, atrioventricular valve malformations and riding in 24 cases, atrioventricular septal defect in 26 cases, 87 cases of ventricular septal deformity, left heart hypoplasia syndrome in 17 cases, right heart hypoplasia syndrome 9 cases, tetralogy of Fallot in 12 cases, ventricular double outlet in 21 cases, aortic transposition in 20 cases, ventricular single outlet in 21 cases, aortic valve malformation in 14 cases; pulmonary valve malformations in 28 cases; aortic proximal deformity in 73 cases, 26 cases of pulmonary arterial malformation, 18 cases of arterial catheter deformity, 6 cases of coronary artery malformations and 5 cases of right heart. Common deformities were ventricular septal defect (56%), atrial septal defect (36%), permanent left superior vena cava 35 (17.5%), single ventricular 31 (15.5%), aortic arch hypoplasia 25 Bit aortic arch 23 (11.5%). CONCLUSIONS: Fetal CHD has a high incidence of ventricular septal defect, atrial septal defect, persistent left superior vena cava, single ventricle and aortic arch dysplasia. Fetal cardiovascular malformations have many variations and blood vessels are small, and each branch should be carefully searched for anatomy.