摘要
目的 探讨超声心动图对胎儿动脉导管早闭的诊断及影像学特点.方法 选择2014年1月至2016年6月经产后确诊的7例动脉导管早闭的胎儿超声心动图资料进行分析,测量指标包括右心房和右心室直径、三尖瓣反流速度,估测右心室收缩压、肺动脉内径、肺动脉瓣反流速度.于患儿出生后24 h内及3个月分别进行心脏彩超复查并测量以上指标.结果 7例早闭胎儿超声心动图未显示动脉导管及血流信号,同时还表现为右心增大,右心房直径平均为14.4 mm,右心室直径平均为14.8 mm;三尖瓣均有轻中度以上反流,三尖瓣反流速度平均367 cm/s,估测右心室收缩压平均为61 mmHg（1 mmHg=0.133 kPa）;所有胎儿肺动脉均有不同程度的增宽,与主动脉内径比值〉1.2,肺动脉平均内径10.2 mm;肺动脉瓣均有轻中度以上反流,肺动脉瓣反流速度平均247 cm/s.患儿在出生后24 h内复查超声心动图结果：7例患儿未探及动脉导管及血流信号;右心房直径平均降至13.8 mm,右心室直径平均降至11.8 mm;三尖瓣反流速度明显下降,平均247 cm/s,估测右心室收缩压平均为19 mmHg;所有患儿肺动脉增宽均有好转,肺动脉平均内径9.1 mm.3个月后再次进行超声心动图复查结果：右心房和右心室直径、肺动脉压力均恢复正常范围.5例患儿三尖瓣反流消失,2例存在轻度三尖瓣反流.结论 有效利用三血管气管切面和动脉导管弓切面对胎儿动脉导管早闭及早发现并结合肺动脉高压及右心负荷过重的超声表现,对病情的判断具有重要的参考价值。
Objective To investigate the echocardiography diagnosis and imaging features of prenatal closure of the fetal ductus arteriosus.Methods From January 2014 to June 2016, 7 cases of prenatal closure of the fetal ductus arterious were selected.The diagnosis were confirmed by echocardiography after delivery.The indexes including the right atrium diameter, right ventricular diameter, tricuspid valveregurgitation velocity, estimated right ventricular systolic pressure, pulmonary artery diameter, and pulmonary valves regurgitation velocity were mesured.In 24 hours and 3 months after birth respectively, the echocardiography indicators above were evaluated again.Results All of the 7 cases of prenatal closure of the fetal ductus arteriosus did not show ductus arteriosus and blood flow signal in echocardiogram.At the same time, it also showed the rightchambers enlargement.The average diameter of right atrium was 14.4 mm, right ventricle was 14.8 mm.Tricuspid valve regurgitation were mild to moderate or more serious.Average tricuspid valve regurgitation velocity was 367 cm/s and estimated right ventricular systolic blood pressure was 61 mmHg（1 mmHg=0.133 kPa）.All fetal pulmonary arteries broadened in a different degree.Average diameter of pulmonary artery was 10.2 mm while pulmonary artery and aortic diameter ratio was 〉1.2.Pulmonary valve regurgitation were mild to moderate or more serious and regurgitation velocity averaged 247 cm/s.The results of echocardiography in 24 h after birth were reviewed.Ductus arteriosus and blood flow signal were not detected in all 7 cases.Right atrial diameter was reduced to 13.8 mm and right ventricular diameter to 11.8 mm.Average tricuspid valve regurgitation velocity was significantly reduced to 247 cm/s and estimated right ventricular systolic blood pressure was 19 mmHg.The average diameter of pulmonary artery in all patients was improved, and the average diameter was 9.1 mm.After 3 months, right atrial and right ventricular diameter and pulmonary arterial pressure were all recovered to normal range.In 5 cases, tricuspid valveregurgitation disappeared.The rest 2 cases had mild tricuspid valve regurgitation.Conclusions For comprehensive judgment of prenatal closure of the fetal ductus arteriosus patients＇ condition, it is important to detect early the three vessel trachea view and the ductus arteriosus view and combined with pulmonary arterial hypertension and right heart overload of ultrasonic performance.
出处
《中国实用医刊》
2017年第14期84-86,共3页
Chinese Journal of Practical Medicine
关键词
动脉导管
早闭
胎儿
超声心动图
Fetal ductus arteriosus
Prenatalclosure
Fetus
Echocardiogram
