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目的探讨昆山市新生儿先天性心脏病筛查及管理模式。方法 2011年8月至2012年12月对昆山市出生的活产儿22 212例,在生后7 d内筛查先天性心脏病,对于初筛阳性的新生儿用彩色多普勒超声心动图进行确定诊断,对彩超诊断异常患儿定期随访。结果初筛新生儿中确诊心脏彩超异常334例,其中房间隔缺损(ASD)86例,室间隔缺损(VSD)66例,动脉导管未闭(PDA)120例,法洛四联症(TOF)3例,复杂性先天性心脏病(CCHD)1例,肺动脉狭窄(PS)5例,其他合并两种及以上先天性心脏异常53例。昆山市初筛儿童中心脏彩超异常发生率为1.5%,其中以PDA(0.56%)最高,ASD次之(0.53%)。对334例心脏彩超异常患儿进行定期随访,其中手术23例(6.89%),缺损自行闭合93例(27.84%),失访83例(24.85%),需进一步干预138例(41.31%)。结论新生儿先天性心脏病病筛查-转诊-干预模式有助于提高先天性心脏病检测筛查水平。
Objective To investigate the screening and management of neonatal congenital heart disease in Kunshan City. Methods From August 2011 to December 2012, 22 212 live births born in Kunshan were screened for congenital heart disease within 7 days after birth. Color Doppler echocardiography was performed on newly diagnosed neonates. Determine the diagnosis of ultrasound diagnosis of abnormal children with regular follow-up. Results A total of 334 neonates with abnormal color Doppler echocardiography were enrolled. Among them, there were 86 ASDs, 66 VSDs, 120 PDA, TOF - 3 cases of complex congenital heart disease (CCHD) in 1 case, pulmonary stenosis (PS) in 5 cases, and other combined two or more congenital heart abnormalities in 53 cases. The incidence of visceral ultrasonography in the screening center of Kunshan City was 1.5%, of which PDA (0.56%) was the highest, followed by ASD (0.53%). A total of 334 children with abnormal color Doppler echocardiography were followed up. Among them, 23 cases (6.89%) were treated by surgery, 93 cases (27.84%) were closed by themselves, and 83 (24.85%) were lost. 138 cases (41.31%) needed further intervention. Conclusion Neonatal screening for congenital heart disease - referral - intervention model can help to improve the detection of congenital heart disease screening.