彩色多普勒超声对诊断儿童先天性心脏病的价值研究

【摘要】 目的:探讨彩色多普勒超声(CDU)对儿童先天性心脏病类型诊断,并对其预后进行判断的临床应用价值。方法:回归性分析收治250例儿童先天性心脏病的彩色多普勒超声特点,并随访0.5～2年,以观察其预后情况。结果:左向右分流型180例(72.0%),右向左分流型52例(20.8%),无分流型18例(7.2%),单纯畸形中以室间隔缺损发病率最高发,检测出51例(20.4%)。房、室间隔缺损管径<4mm者,随年龄增长,80.7%可自然闭合;缺损4～6mm者,52.4%可自然关闭;>6mm者,80%需要手术治疗。对于动脉导管未闭患儿,管道直径<2mm者,随访2年,87.5%可关闭;导管未闭2～4mm者,60.0%可愈合;动脉导管>4mm者,100%需要手术治疗。合并其他心血管畸形如肺动脉狭窄或闭锁、大动脉转位、肺静脉异常等的重症先心病患者,其死亡率高达89%。结论:彩色多普勒超声能早期对儿童先天性心脏病做出准确的诊断,并对部分类型先心病预后做出评估和预判,从而为指导临床治疗有比较高的应用价值。更多还原

【Abstract】 Objective:To explore Color Doppler Ultrasound(CDU)in diagnosis of the type of congenital heart disease in children,and the clinical value in judgement of theirs prognosis.Method:we made a regression analysis of the characteristics of Color Doppler ultrasound in 250 cases children with congenital heart disease,and observed theirs prognosis with follow-up of 6 months to 2 years.Result:In all the cases,left to right shunt in 180 cases(72.0%),right-to-left shunt in 52 cases(20.8%),no shunt in 18 cases(7.2%),the highest incidence of congenital heart disease was Ventricular septal defect,was detected in 51 cases(20.4%).When the diameter less than 4mm in atrial septal defect and ventricular septal defect,80.7% of patients could be natural closed,and only 52.4% natural close in the defect diameter between 4mm and 6mm,while the defect diameter more than 6mm,80% require surgery.For the patients of patent ductus arteriosus with the pipeline diameter less than 2mm,87.5% of the patients could be natural closed,and 60.0% natural close in the defect diameter between 2mm and 4mm,while the defect diameter more than 4mm,100% require surgery.Severe congenital heart disease patients combined with other cardiovascular malformations such as pulmonary stenosis or atresia,transposition of great arteries,pulmonary vein anomalies,the mortality rate of up to 89%.Conclusion:Color Doppler ultrasound can early make an accurate diagnosis of children with congenital heart disease,and can make a prognosis assessment for some types of congenital heart disease,and also has a high value to guide clinical treatment.更多还原