目的 探讨联合多切面超声心动图诊断妊娠中期胎儿先天性心脏病（CHD）的临床价值。方法 回顾性分析2011年1月至2017年3月在本院常规产前超声检查及外院来我院会诊的可疑心脏结构异常，并行超声心动图检查的165例中期妊娠胎儿病例资料，将超声心动图检查结果与最终尸检结果进行对照，比较两者的差异。结果 ① 超声诊断并经尸检证实胎儿先天性心脏病共107例（64.85%），其中单纯型26例，占24.30%，复杂型81例，占75.70%。②存在室间隔缺损（VSD）共67例，占62.62%，发病率最高，包括单纯型VSD12例（17.91%），复杂型55例（82.09%）。③107例CHD引产后与尸体解剖相对照，两者完全符合87例，占81.3%；基本符合13例，占9.88%，不符合者7例，占6.54%。④超声心动图诊断复杂型CHD与尸检结果具有良好的一致性，Kappa值0.809（P=0.00），其敏感度和特异度分别为94.12%和90.91%。 结论 联合多切面技术的超声心动图对胎儿CHD产前筛查具有较高准确性，是产前筛查胎儿CHD的重要方法，具有操作简便、敏感度等优点，具有很高的临床应用价值。
Objective To discuss the clinical value of combined multifaceted echocardiography in diagnosis of fetal congenital heart disease (CHD) in midtrimester pregnancy. Method 165 cases suspicious fetal CHD detected by echocardiography in obstetrical department of our hospital from January 2011 to March 2017 were enrolled, and comparing the different results between the fetal echocardiography and autopsy. Results ①107(64.85%)CHD cases were confirmed by ultrasound and autopsy, including simple type 26 cases, accounted for 40%, and complex style 81 cases，accounted for 75.70%. ② 67 cases suffered from ventricular septal defect (VSD), accounted for 62.62% with the highest incidence. Of 67 VSD cases, including simple style 12 cases (17.91%) and complex style 55 cases (82.09%). Besides, all 20 cases with double outlet right ventricle underwent VSD. ③107 CHD cases were compared between echocardiography autopsy after elective surgery, perfectly consistent in 87 cases (81.3%), basically consistent in 13 cases(9.88%) and inconformity in 7 cases (6.54%). ④ There was good consistency between the between echocardiography autopsy exmination, the Kappa was 0.809（P=0.00), and the Sensitivity and specificity was 94.12% and 90.91%. Conclusions Combined multifaceted echocardiography had a high accuracy in diagnosis of CHD in midtrimester pregnancy, and it was an important for CHD prenatal screening.
