探讨胎儿心脏超声筛查在先天性心脏病中的诊断价值。

选取临沂市人民医院2017年10月至2019年5月确诊的56例先天性心脏病胎儿，均经引产手术后病理学检查确诊，术前分别接受了四维心脏超声和二维心脏超声进行筛查检测，作为四维组和二维组，比较两组先天性心脏病检出率和检出类型。

四维组检出率明显高于二维组(96.43%比82.14%)，差异有统计学意义(P＝0.015)。56例先天性心脏病患儿中，法洛四联症8例，大动脉移位11例，室间隔缺损14例，房间隔缺损13例，心内膜垫缺损10例。两组在法洛四联症、大动脉移位、室间隔缺损、心内膜垫缺损类型中检出率无明显差异(P>0.05)。四维组在房间隔缺损检出率明显高于二维组，差异有统计学意义(P＝0.030)。

胎儿心脏超声筛查在检测先天性心脏病中的诊断价值较高，相对于二维彩超，四维超声具有更高检出率，值得进一步推广应用。

To explore the diagnostic value of fetal echocardiography screening in the detection of congenital heart disease.

A total of 56 fetuses with congenital heart disease diagnosed in Linyi People′s Hospital from October 2017 to May 2019 were selected, and all of them were confirmed by pathological examination after labor induction surgery.All fetuses were screened by four-dimensional echocardiography and two-dimensional echocardiography before surgery, respectively, as the four-dimensional group and the two-dimensional group.The detection rate of congenital heart disease was compared between the two groups, and the detection types of congenital heart disease were compared between the two groups.

The detection rate in the four-dimensional group was significantly higher than that in the two-dimensional group(96.43% vs.82.14%), with a statistically significant difference(P=0.015). Among the 56 children with congenital heart disease, there were 8 cases of tetralogy of Fallot, 11 cases of transposition of great arteries, 14 cases of ventricular septal defect, 13 cases of atrial septal defect and 10 cases of endocardial pad defect.There were no significant differences in the detection rates of tetralogy of Fallot, transposition of great arteries, ventricular septal defect and endocardial pad defect between the two groups(P>0.05). The detection rate of atrial septal defect in the four-dimensional group was significantly higher than that in the two-dimensional group(P=0.030).

Fetal echocardiography screening has a higher diagnostic value in the detection of congenital heart disease.Compared with two-dimensional color ultrasound, four-dimensional ultrasound has a hither detection rate, which is worthy of further application.