| 李 倩,孙 杰,牟孙凡,贾红娥,王 媛.产前超声诊断结果与胎儿先天性心脏病结局的相关性及危险因素分析[J].,2023,(3):555-559 |
| 产前超声诊断结果与胎儿先天性心脏病结局的相关性及危险因素分析 |
| Correlation and Risk Factors Analysis of Prenatal Ultrasound Diagnosis Results and Fetal Congenital Heart Disease Outcomes |
| 投稿时间：2022-05-07 修订日期：2022-05-31 |
| DOI：10.13241/j.cnki.pmb.2023.03.031 |
| 中文关键词: 先天性心脏病 产前超声 危险因素 高龄孕妇 多普勒超声 |
| 英文关键词: Congenital heart disease Ultrasound examination Risk factors Elderly pregnant women Doppler ultrasound |
| 基金项目:陕西省科技厅一般项目（2020SF-237） |
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| 中文摘要: |
| 摘要 目的：对比先天性心脏病胎儿与正常胎儿的产前超声差异，分析产前超声诊断结果与胎儿先天性心脏病的相关性及危险因素。方法：选取我院2018年12月到2020年12月共收治的80例有先天性心脏病胎儿的孕妇作为研究对象，将其分为观察组，另选取健康胎儿的80例孕妇进行对比研究，将其分为对照组，对所有孕妇进行彩色多普勒超声进行诊断，分析观察组超声诊断与最终结果，对比两组胎儿的超声诊断情况，并对孕期胎儿先天性心脏病的风险因素进行单因素与多因素logistic回归分析。结果：通过尸检和出生后随访最终确定结果与超声诊断结果对比无显著差异（P＞0.05），超声诊断中有3例漏诊；由于卵圆孔直径大于6 mm、心内膜垫缺损（Endocardial cushion defect, ECD）和单心房胎儿没有正常的四腔心结构，因此无法进行腔室内径的测量，对其他观察组患儿进行测量之后发现，观察组患儿左心发育不全综合征（hypoplastic left heart syndrome, HLHS）的左心房与左心室、法洛氏四联症（Tetralogy of Fallot, TOF）右心室、室间隔缺损（Ventricular Septal Defect, VSD）右心室内径明显低于对照组（P＜0.05）；对可能造成胎儿先天性心脏病的高风险因素进行分析发现，两组孕妇的孕期早期服药、高龄产妇以及家族心脏病史情况对比差异显著，观察组明显更高（P＜0.05）；对所有因素进行赋值，其中"是"或"有"为1，"否"或"无"为0。通过logistic回归分析发现只有孕期早期服药和家族心脏病史为胎儿先天性心脏病的独立危险因素（P＜0.05）。结论：对孕妇进行综合产前超声诊断胎儿先天性心脏病的准确率较高，与最终结果无明显区别；虽然高龄孕妇与胎儿先天性心脏病具有一定关系，但是只有孕期早期服药和家族心脏病史是胎儿先天性心脏病的独立危险因素。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the difference of ultrasound examination between the fetus with congenital heart disease and the normal fetus, and to analyze the correlation and risk factors between the results of prenatal ultrasound diagnosis and fetal congenital heart disease. Methods: 80 cases of pregnant women with congenital heart disease in our hospital from December 2018 to December 2020 were selected as the research object, and they were divided into the observation group, another 80 cases of pregnant women with healthy fetus were selected for comparative study, and they were divided into the control group, all pregnant women were diagnosed by color Doppler ultrasound, the ultrasonic diagnosis and final results of the observation group were analyzed, and the differences between the two groups were compared The risk factors of fetal congenital heart disease during pregnancy were analyzed by univariate and multivariate logistic regression. Results: There was no significant difference between the results determined by autopsy and postnatal follow-up and the results of ultrasound diagnosis (P>0.05), and there were 3 cases of missed diagnosis in ultrasound diagnosis. There was no normal four chamber structure in the fetuses with HLHS, ECD and single atrium, so it was impossible to measure the inner diameter of the chambers. After measuring other children in the observation group, it was found that the inner diameters of the left atrium and left ventricle, TOF right ventricle and VSD right ventricle in the observation group were significantly lower than those in the control group (P<0.05) There were significant differences in early pregnancy medication, elderly women and family history of heart disease between the two groups, and the observation group was significantly higher (P<0.05); all factors were assigned values, in which "yes" or "yes" was 1, and "no" or "no" was 0. Logistic regression analysis showed that only taking medicine in early pregnancy and family history of heart disease were independent risk factors of fetal congenital heart disease(P<0.05). Conclusion: The accuracy of comprehensive ultrasound examination for pregnant women in the diagnosis of fetal congenital heart disease is high, and there is no significant difference with the final result; Although there is a certain relationship between elderly pregnant women and fetal congenital heart disease, only early medication during pregnancy and family history of heart disease are independent risk factors of fetal congenital heart disease. |
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