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目的探讨新生儿先天性心脏病(先心病)临床筛查的有效方法。方法利用8项临床筛查指标(先心病家族史、胎儿期心脏超声异常、呼吸困难、青紫、特殊面容、心脏听诊、新生儿先天畸形、血氧饱和度监测)对新生儿进行先心病筛查,对筛查出的先心病患儿进行诊断、评价、跟踪、随访,并对各项筛查指标进行灵敏度、可疑度、阳性预测值、阴性预测值进行分析,找出最简单有效筛查方法。结果利用8项临床指标筛查新生儿先心病,共筛查5 965例新生儿,符合筛查阳性病例75例(1.26%),心脏超声异常43例(0.72%),12个月随访终结时确诊先心病32例(5.36‰)。结论 8项临床指标筛查新生儿先心病是可靠手段,新生儿心脏听诊+胎儿心脏彩超异常+经皮血氧饱和度3项指标的组合及心脏听诊+经皮血氧饱和度2项指标的组合在筛查新生儿先心病方面具有与8项指标相同的灵敏度,适合推广。
Objective To explore the effective method of clinical screening of congenital heart disease (congenital heart disease) in neonates. Methods The screening of neonates with congenital heart disease was carried out using 8 clinical screening indicators (family history of congenital heart disease, abnormal fetal cardiac ultrasound, dyspnea, bruising, special face, cardiac auscultation, congenital malformation of newborn and oxygen saturation monitoring) , Diagnosed, diagnosed, followed up and follow-up of the children with CHD. The sensitivity, suspiciousness, positive predictive value and negative predictive value of each screening index were analyzed to find out the most simple and effective screening method . Results A total of 5 965 newborns were screened for neonatal CHD using 8 clinical indicators. The results showed that 75 cases (1.26%) were positive for screening, 43 cases (0.72%) had abnormal cardiac ultrasound. At the end of 12 months follow-up Confirmed congenital heart disease in 32 cases (5.36 ‰). Conclusion Eight clinical indicators of screening for neonatal CHD are reliable, neonatal auscultatory heart + fetal ultrasound and percutaneous oxygen saturation of three indicators of the combination of auscultation and auscultation + percutaneous oxygen saturation of two indicators Combination in screening neonatal congenital heart disease with 8 indicators with the same sensitivity, suitable for promotion.