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目的:探讨产前超声心动图在胎儿左心室发育不良综合征(hypoplastic left heart syndrome,HLHS)临床诊断中的应用价值。方法:选择在桂林医学院附属医院接受检查的孕18~40周10 928胎,经产前超声心动图检查发现24例胎儿存在左心室发育不良综合征,对其胎儿超声心动图进行了回顾性分析。结果:对孕18~40周10 928胎进行产前超声心动图进行检查发现24例胎儿存在左心室发育不良综合征,全部经引产后病理证实,超声诊断符合率100%。按照《胎儿心脏病理解剖与超声诊断学》中关于左心室发育不良综合征分型标准进行分型分析,其中I型4例,Ⅱ型9例,Ⅲ型3例,Ⅳ型8例。左心室发育不良综合征胎儿的左、右房室及瓣环径比值与正常胎儿相比较明显降低,且差异具有统计学意义(t=4.65、4.02、3.52,P<0.05)。结论:胎儿超声心动图作为一种安全、便捷、经济及有效的检查方法,可以早期诊断胎儿左心室发育不良综合征,其中二维超声心动图是根本,而多普勒超声和M型超声心动图也不可或缺。
Objective: To investigate the value of prenatal echocardiography in the clinical diagnosis of fetal hypoplastic left heart syndrome (HLHS). Methods: A total of 10 928 fetuses aged from 18 to 40 weeks were enrolled in the Affiliated Hospital of Guilin Medical College. Prenatal echocardiography was performed to detect the presence of left ventricular dysplasia syndrome in 24 fetuses. The fetal echocardiography was retrospectively reviewed analysis. Results: Prenatal echocardiography was performed on 10 928 fetuses from 18 to 40 weeks of gestation. Twenty-four fetal left ventricular dysplasia syndromes were found. All of them were confirmed by pathology after the induction of labor and the coincidence rate of ultrasound diagnosis was 100%. According to “Fetal Cardiac Pathology and Anatomy and Ultrasound Diagnostic” in the classification of left ventricular dysplastic syndrome classification criteria, including type I in 4 cases, type II in 9 cases, type III in 3 cases, type IV in 8 cases. Left ventricular dysplasia syndrome, left ventricular and left ventricular systolic and left ventricular ring diameter ratio was significantly lower than the normal fetus, and the difference was statistically significant (t = 4.65,4.02,3.52, P <0.05). Conclusion: Fetal echocardiography is a safe, convenient, economical and effective method for the early diagnosis of fetal hypoplastic left ventricular dysplasia. Among them, two-dimensional echocardiography is essential, while Doppler ultrasound and M-mode echocardiography Figure is also essential.