A Study On The Factors Affecting The Natural Turnover Of Ivsd

ObjectiveObservation of fetal simple Ventricular septal defect of natural conditions, and on the impact of simple Ventricular septal defect natural healing related factors. Congenital heart disease (CHD) is most common in children with congenital malformations, by environmental factors and the role of genetic factors, multiple genes inherited diseases, the incidence rate of about 0.6% 1.2%. According to statistics, China's congenital heart disease incidence in the normal population is approximately 8‰, is the most common newborn congenital malformation, is also an important neonatal and infant mortality. Every year the birth of children with congenital heart disease is about 15 million, isolated Ventricular septal defect is congenital heart disease in the most common type, accounting for about 25% to 40% of the total. Defects may occur in any part of the interventricular septum, such as film, outflow, and muscle. In some cases can intrauterine or within 3 years, after the birth defect gradually become smaller or natural healing. At present, the research more Echocardiogram screening and diagnosis of fetal period each kind of congenital heart disease and how to improve the accuracy of the diagnosis. In Stiimpflem, and more research emphasized the fetal echocardiography heart defect and other cannot diagnose the importance of the chromosome aberration, sensitivity of 88.5%, specificity 100% prenatal diagnosis of congenital heart disease the ultimate goal is to improve the prognosis. Maternal fetal echocardiography found serious malformations of the heart, eugenics of labor become obstetric clinic treatment. By screening, parents in prenatal was told the diagnosis of congenital heart disease, severity and prognosis is, severe complex malformations fetus timely termination of pregnancy. Accurate antenatal examination structure helps select the best delivery time, for the early treatment of newborn infants, to establish the correct congenital heart disease treatment options have a good guideline. The clinic also determines the necessary prenatal and postnatal care, thereby enhancing serious survival of infants. Echocardiography as a way to the fetus and the mother are non-invasive method of checking, Winsberg1972, the first reported use of M-fetal heart of results. In the early 1980s, Kleinmanji and Allan had established fetal echocardiography method, launched a prenatal diagnosis of congenital heart disease. With the rapid development of perinatal medicine, fetal echocardiography of applications, has been able to more accurately evaluate fetal cardiac structure and hemodynamics, available on most of the fetus to prenatal diagnosis of congenital heart disease. Fetal ultrasound ECG can be non-traumatic probe into the heart of fetal stages and internal diameter of the great vessels and heart valves, hemodynamics and fetal cardiac rhythm, etc., is not only an early diagnosis of congenital heart disease is safe and reliable means, more to further improve the prognosis of congenital heart diseases, improve neonatal survival to create good conditions. A large number of clinical data prove, congenital heart disease of prenatal monitoring will greatly improve the complex congenital heart disease, especially in the catheterization dependent diabetes and cardiac, vascular severe Dysplasia of congenital heart disease are serious cyanosis and acidosis. In recent years abroad has carried out-of-the-art surgical intervention in utero fetal congenital heart disease, some make the treatment of congenital heart disease have a significant breakthrough. To do this, we use color Doppler ultrasound screening for gestational age in 20 instrument-28 weeks pregnant women. In the heart of four Chamber view, left ventricular outflow tract and aortic long axis slice and other heart more slices, observation of Ventricular septal whether echo interrupt and wear other blood flow. Find positive patients, to guide the children for the clinical examination, to merge the other malformations or other chromosomal abnormalities and other diseases; and conduct clinical Ventricular septal defect, and surgical treatment of time eugenics is important.Research methods:For more than 20 weeks of pregnancy, to pregnant women and giving the fetus necessity of congenital heart disease, as well as present echocardiography can screening and diagnosis of fetal heart disease categories, agreed after line of fetal cardiac ultrasound examination. Pregnant women supine, choice of fetal cardiac conditions, probe into maternal abdominal wall sliding, first determine fetal position, longitudinal scan fetal spine, probe rotate 90 degrees, crosscutting fetal cardiac chest being distinct four Chamber view, in this section of the observation by two-dimensional and a broad scale, proportion and atrioventricular cavity size, mitral and tricuspid valve (location, development, and open the case, there is no atrial septum, oval hole size, Ventricular septal continuity and whether there is a space-occupying lesions, and so on, change the beam direction for left ventricular long axis slice, but short axis slice, left ventricular outflow tract, right ventricular outflow tract and aorta and pulmonary long axes, and other slice, further study of fetal cardiac and vascular structures, forms; positive case before delivery (37-40 weeks) once, record the same project-related data. Postpartum month using echocardiography review neonates, for children and of children, every six months follow-up review, follow-up of 3 years. Each group of data entry SPSS12.0 statistical software, the software process, look for related factors and correlation coefficient. Fetal confirmed Ventricular septal defect before review after giving birth. After a month use color Doppler ultrasound reinspection neonatal cardiac instrument, for Ventricular septal defect is an unclosed children, every six months follow-up review once, continuous follow-up of 3 years. The two color Doppler ultrasonography is not found to confirm AV streaming Ventricular septal defect of healing. Using computer software SPSS 15.0 single factors and factors related to statistical analysis.Results:1, Simple Ventricular septal defect 126 cases, where labor front defect intrauterine natural healing in 2 cases, after giving birth to complete follow-up 86 cases.2,86 cases, surgical treatment of 17 cases, postnatal Ventricular septal defect natural healing 55 cases,10 cases of defect follow-up 3 years is still not healing,4 cases of early postnatal complications due to different.3,55 cases,12 months defect natural healing and 28 cases,49.1 percent,24 months defect natural healing 52 cases, only 91.2%, average (13.7±8.5). 4, The natural healing of peak in 24 months.5,Ventricular septal defect occurred in 52 cases muscle of 48 cases of natural healing, accounted for 92.3%, occur in Ventricular septal upper section 14 cases of nine cases of natural healing,64.3%, and different parts of the natural healing rate of defects by the Chi-square test confirmed that there are significant differences between (χ2=7.355, P=0.007<0.05))6,Affect Ventricular septal defect natural healing time related factors:VSD infant within 3 years of natural healing time varies, break it into 1-12 months,13-24 months and 25-36 months three stages, the defect parts of VSD, size and other blood flow velocity, and the relationship between defect healing time.7. the defect parts and Ventricular septal defect healing relationship: Ventricular septal defect, muscles before and after 0-12 months natural healing of sample size and more, for 26 cases (54.2%), and Ventricular septal defect is on postnatal 13-24 months natural healing of sample size and more,7 patients (77.8%), but in different parts of defect in different time periods of natural healing rate of no significant difference in ((χ2=5.742,P=0.057))8. the Ventricular septal defect size, left-right shunt and right-left shunt speed and Ventricular septal defect natural healing relationship, the result looks like this:defect size and right-left shunt speed for Ventricular septal defect of natural healing effects, there are differences are statistically (P is≤0.05), the smaller the defect, right-left shunt the small, the likelihood of a natural healing. Left-right Division of speed on the VSD self-healing rate no appreciable effect.9. the Ventricular septal defect size, left-right shunt and right-left shunt speed and Ventricular septal defect natural healing time constraint, the result looks like this: defect size on Ventricular septal defect natural healing effects, sooner or later have a defect with the smaller natural healing time sooner, differences are statistically (P< 0.01). While the left-right and right-left shunt speed on Ventricular septal defect natural healing and evening has no effect.Conclusions:1, Age and Ventricular septal defect of natural healing are very closely related, born within 24 months after the natural healing of the weak..2, Ventricular septal defect parts, other factors such as blood flow velocity on infant Ventricular septal defect natural healing. Different defect parts of natural healing rates there are significant differences between (χ2=7.355, P=0.007<0.05)3. Ventricular septal defect parts in different for different time periods natural healing rate no obvious difference in (χ2=5.742,P=0.057)。4. Ventricular septal defect size and right-left shunt speed for Ventricular septal defect of natural healing effects, there are differences are statistically (P is≤0.05), the smaller the defect, right-left shunt the small, the likelihood of a natural healing.5. the ventricular shunt and the left-right and right-left shunt speed on Ventricular septal defect natural healing and evening has no effect.6. study results to guide clinical Ventricular septal defect with eugenics is important...