摘要
目的:比较分析胎儿复杂性先天性心脏病(CHD)产前诊断与出生后诊断处理的价值及预后情况。方法:回顾性分析在我院产检诊断为胎儿复杂性CHD,经产前咨询保留胎儿,并在本院分娩,出生后转NICU进一步诊治(产前诊断组)与院外分娩后诊断为复杂性CHD,出生后72小时内转我院NICU诊治(产后转诊组)患儿的分娩结局及预后,并进行比较。结果:产前诊断组共106例,产后转诊组共129例。产前诊断组经产前咨询,30例家属放弃胎儿并引产,76例保留胎儿并在我院分娩。两组分娩孕周、出生体重、早产率和分娩方式比较,差异无统计学意义(P>0.05)。两组出生后放弃治疗(6例vs 31例)、小儿心脏外科评估认为无需手术治疗及可随诊(30例vs 14例)、心脏手术后并发症(20例vs 56例)间比较,差异有统计学意义(P<0.05);手术后死亡、呼吸机脱机时间和手术后住院天数间比较,差异无统计学意义(P>0.05)。结论:产前明确胎儿复杂性CHD的诊断,可减少患儿心脏手术后并发症,改善预后。并且可避免一些无治疗价值的复杂性先天性心脏病新生儿的出生。
Objective： To compare and analysize the treatment value and prognosis in fetal with complex congenital heart diseases by prenatal and postnatal diagnosis. Methods： Pregnancy outcome and prognosis were analysized retrospectively in fetal from prenatal diagnosis group and postpartum referral group in January 2012 to December2014. Prenatal diagnosis group was defined as the fetal with complex congenital heart disease by prenatal diagnosis,who were retained after antenatal consultant and transferred to NICU after birth in our hospital. Postpartum referral group was defined as the fetal who were diagnosed with complex congenital heart disease in other hospitals and sequencely transferred to NICU in our hospital in 72 hours after birth. Results： This study include 106 cases of prenatal diagnosis group and 129 cases of postpartum referral group. Through prenatal counseling,30 cases in prenatal diagnosis group were given up and induced labor,the other 76 cases were retained and born in our hospital. There was no statistically significant difference between prenatal diagnosis group and postpartum referral group in gestational age,birth weight,premature delivery rate and childbirth way（ P 0. 05）. The differences between the two groups in cases of giving up treatment after birth,cases that needed follow-up,not surgery by pediatric cardiology assessment,and postoperative complications were statistically significant（ P0. 05）. There was no significant difference in the death cases after operation,the ventilator weaning time and surgical hospitalization days（ P0. 05）. Conclusions： The diagnosis of fetal with complex congenital heart diseases by prenatal diagnosis can reduce the complications after surgery,improve prognosis,and avoid the birth of some fetal with no therapeutic value.
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2016年第1期45-48,共4页
Journal of Practical Obstetrics and Gynecology
基金
广东省医学科学技术研究项目(编号:C2012013)
关键词
胎儿
先天性心脏病
产前诊断
治疗
Fetal
Congenital heart disease
Prenatal diagnosis
Treatment
