【摘要】 目的:探讨各种胎儿先天性心脏病(简称先心病)的围生儿结局和预后,为产前咨询、产后处理提供证据。方法:回顾性分析2005年1月至2009年12月在广东省人民医院产前和(或)产后经彩色超声心动图检查诊断为胎儿先心病151例的临床资料,并分析随访至出生后1～5年的情况。结果:我院的胎儿先心病的发生率为1.25%(151/12056),其中活产104例,引产45例(包括死胎引产1例),死产2例;存活95例,死亡9例(自然死亡6例,心脏矫形术后死亡3例)。简单型先心病占41.06%(62/151),其中61.29%(38/62)是产后诊断,存活率91.94%(57/62)。复杂型先心病占58.94%(89/151),<28孕周诊断者占42.70%(38/89),复杂型先心病的引产率46.07%(41/89),存活率42.70%(38/89)。产前诊断的98例胎儿先心病仅有67例产前行胎儿染色体核型分析,染色体异常发生率为16.42%(11/67)。151例胎儿先心病共有25例患儿行心脏矫形手术治疗,其中简单型先心病8例(术后均存活),复杂型先心病17例(术后死亡3例)。结论:简单型先心病可出生后观察、随访,预后好;近一半复杂型先心病可以在28周内明确诊断,某些复杂畸形可以经医患双方充分沟通后,决定是否引产或出生后限期手术;应重视对胎儿先心病的染色体异常进行产前诊断。更多还原

【Abstract】 Objective:To investigate the perinatal outcome and prognosis of various fetal congenital heart disease(CHD) to provide evidence for prenatal consultation and postnatal treatment.Methods:A retrospective analysis of 151 cases of CHD diagnosed by fetal echocardiography prenatal or/and postnatal was done in Guangdong general hospital from Jan.2005 to Dec.2009,these fetus were followed up for 1 to 5 years after birth.Results:Incidence of CHD was 1.25%(151/12056),104 were live birth,45 cases were abortion(including a dead fetus),2 were stillbirth;95 CHD neonates survived,9 babies were dead(6 were natural death and 3 death happened after operation).Simple CHD accounted for 41.06%(62/151)and had a high survival rate(91.94%,57/62),among which 61.29%(38/62)were diagnosed after delivery.Complex CHD accounted for 58.94%,of which 42.70%(38/89)were diagnosed before 28 weeks.The induced abortion rate was 46.07%(41/89),the survival rate was 42.70%(38/89).In the prenatal diagnosed group,67 fetus had karyotype analysis,of which 11 cases(16.42%) were chromosomal abnormality.25 of 151 cases were treated by surgery,among which 8 were simple CHD(all survived)and 17 were complex type(3 were dead after operation).Conclusions:Simple deformity can be followed up after delivery,the prognosis is good.Almost half complex CHD can be diagnosed before 28 weeks,some complex type can be corrected after delivery.Attention should be paid to prenatal screen of abnormal chromosome.更多还原