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目的探讨超声“四切面”法,即四腔心切面、左室流出道切面、右室流出道切面和三血管切面筛查胎儿严重先天性心脏病的临床价值。方法应用超声“四切面”法对孕18-24周的15 000例胎儿进行严重先天性心脏病筛查,严重先天性心脏病经超声心动图复查及羊水或脐血染色体核型分析,引产标本基因芯片检测分析。结果 “四切面”法检出胎儿先天性心脏病137例,其中简单型30例(21.8%),简单型中漏诊室间隔缺损8例(26.7%),复杂型107例(18.1%),漏诊3例(2.8%)伴心外畸形8例(5.8%)。结论 “四切面”法简单,易掌握,对产前筛查胎儿严重心脏病(复杂型)具有重要的临床价值,而简单型漏诊率仍存在,因此应用“四切面”法在广大的基层医院来筛查胎儿严重先天性心脏病具有较好的临床实用价值。
Objective To investigate the clinical value of ultrasonography “four-slice ” method, that is, four-chamber view, left ventricular outflow tract section, right ventricular outflow tract section and three-vessel section in screening fetus with severe congenital heart disease. Methods A total of 15 000 fetuses aged 18-24 weeks were screened for severe congenital heart disease by ultrasound and the “four-section method”. The etiology of severe congenital heart disease was examined by echocardiography and the karyotype of amniotic fluid or cord blood was analyzed. Induction of genomic DNA chip detection analysis. Results There were 137 cases of congenital heart disease in fetus, of which 30 cases were simple type (21.8%), 8 cases (26.7%) were simple missed type and 107 cases (18.1%) were complicated type. , Missed diagnosis in 3 cases (2.8%) with malformations in 8 cases (5.8%). Conclusion The simple and easy grasp of the “four-sided” method has important clinical value in prenatal screening of fetal serious heart disease (complex type), and the simple type of missed diagnosis still exists. Therefore, the application of the “four-section method” The majority of primary hospitals to screen for fetal congenital heart disease has good clinical value.