目的探讨产前超声筛查诊断模式改变对胎儿心血管畸形筛查的影响。方法回顾性分析2010-2015年不同超声筛查模式下进行系统超声检查的108 443人的超声检查资料。结果 2010年1月-2015年12月检出胎儿畸形总数3401例,检出率313.62/万,其中心血管畸形的检出率最高,共检出748例,检出率为98.98/万。2013-2015年系统超声对心血管畸形检出率要明显高于2010-2012年;主要心血管畸形室间隔缺损、主动脉及其分支异常、右室双出口、法乐四联征检出率均明显高于2010-2012年。2010-2012年漏诊心血管畸形11例,漏诊率15.49%,2013-2015年漏诊心血管畸形7例,漏诊率3.35%,2013-2015年心脏畸形的漏诊率明显低于2010-2012年,差异有显著统计学意义(P<0.001)。结论产前系统超声联合胎儿超声心动图进行胎儿畸形筛查能显著提高胎儿心血管畸形的筛查率和筛查类型,值得推广。

Objective To discuss the influence of changing prenatal ultrasound diagnostic model on screening cardiovascular malformation. Methods To analysis data of prenatal ultrasound for people in different diagnostic model from 2010 to 2015,the total of people was 108 443. Results The total number of malformation was 3401 and the rate was 3136. 2‰ during Jan. 2010 to Dec. 2015.The highest rate was 989. 8‰ for cardiovascular malformation which the total number was 748. The relevance rate of cardiovascular malformation from 2013 to 2015 was higher than that from 2010 to 2012. The relevance rate of interventricular septal defect,Aortic and aortic branch anomaly,double outlet of right ventricle and tetralogy of fallot from 2013 to 2015 were higher than those during 2013 to2015. The number of missed diagnosis for cardiovascular malformation was 11 from 2010 to 2012 and 7 from 2013 to 2015,the missed diagnosis rate was 15. 49% was and 3. 35% respectively,and the difference was statistically significant( P < 0. 001). Conclusions Prenatal ultrasound combined with fetal echocardiography for fetal malformation screening can significantly improve the fetal cardiovascular malformation screening rate and type,it is worth promoting.