| 摘要: |
| 目的 探讨产前超声诊断胎儿先天性膈疝的临床价值。方法 选取我院确诊的先天性膈疝胎儿75例为病例组，与病例组相同孕周的正常胎儿40例作为正常对照组，回顾性分析病例组胎儿超声表现，测量其健侧肺的肺头比（LHR），并比较两组大脑中动脉及脐血流等相关指标。结果 病例组75例胎儿中，左侧膈疝68例，右侧膈疝7例；单纯性膈疝40例，膈疝合并其他畸形35例，其中心血管系统畸形最常见，其次是神经系统、泌尿系统及骨骼系统等。病例组胎儿LHR＞1.6者33例，合并其他畸形13例；LHR＜1.0者20例，合并其他畸形14例；LHR在1.0～1.6之间者22例，合并其他畸形8例。病例组大脑中动脉峰值流速为（29.03±0.22）cm/s，低于正常对照组（42.11±0.17）cm/s，差异有统计学意义（P＜0.001）；但两组搏动指数、阻力指数比较，差异均无统计学意义。结论 产前超声可以准确诊断先天性膈疝，但怀疑有膈疝时，一定需要注意各个系统的筛查，尤其是心血管系统。了解膈疝胎儿健侧肺的LHR及大脑中动脉血流情况，可能为膈疝胎儿产前管理及生后干预提供更多的参考信息。 |
| 关键词: 先天性膈疝 超声 产前 胎儿 |
| DOI： |
| 投稿时间：2017-07-01修订日期：2018-10-30 |
| 基金项目:胎儿先天性心脏病的遗传与环境因素的应用研究 |
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| Prenatal ultrasound in diagnosis of congenital diaphragmatic hernia |
| Rong Liu |
| (Yichang central People’s Hospital) |
| Abstract: |
| Object To analyze the clinical value of prenatal ultrasound in diagnosis of congenital diaphragmatic hernia(CDH).
Methods 75 cases of CDH and 40 cases of normal fetus were retrospectively analyzed. And the lung-to-head ratio(LHR) and fetal middle cerebral artery were compared in two groups. Results In 75 cases, 68 located on the left and 7 on the right. 44 cases were in the second trimester and 31 in third trimester. However, 35 cases combined with other Prenatal ultrasound featuresmalformations, including cardiovascular system malformation, nervous malformations, urogenital system malformation, skeletal system malformation, and etc. In all cases, 33 showed LHR＞1.6 , 20 in LHR＜1.0 , and 22 in LHR between 1.0 and 1.6. Middle cerebral artery flow velocity was significantly lower in fetuses with CDH than in healthy fetuses (29.03±0.22 VS 42.11±0.17cm/s, P＜0.001), however there were no significant difference in PI and RI (1.50±0.19 VS 1.43±0.13, P＞0.05; 0.73±0.16 VS 0.76±0.23,P＞0.05).Conclusion Prenatal ultrasound can accurately diagnose CDH, Which is often associated with other malformations, we need pay more attention to every system of the fetus, especially cardiovascular system. In addition to, obtaining the lung-to-head ratio and middle cerebral artery flow with CDH may provide more information for prenatal management and intervention after birth.KEY WORDS congenital diaphragmatic hernia；ultrasound；prenatal；fetus |
| Key words: congenital diaphragmatic hernia ultrasound prenatal fetus |
