脉搏血氧仪筛查先天性心脏病的有效性研究  

Effectiveness of pulse oximetry for the screening of congenital heart disease in newborn infants

作　　者：莫兆冬[1] 郭小玲[1] 王维琼[1] 陈小兰[1] 彭嘉恒[1] 

机构地区：[1]广东省中山市博爱医院新生儿科,528400

出　　处：《中国新生儿科杂志》2015年第5期343-346,共4页Chinese Journal of Neonatology

摘　　要：目的探讨脉搏血氧仪筛查先天性心脏病的效果。方法选择2010年1月至2013年12月在我院新生儿科住院且无紫绀的足月新生儿,随机分为脉搏血氧仪组和体格检查组。脉搏血氧仪组应用脉搏血氧仪测量肢体的脉搏血氧饱和度筛查先天性心脏病,体格检查组由医生行心脏听诊筛查先天性心脏病。计算两组筛查的敏感度、特异度、阳性预测值和阴性预测值,记录筛查结果为假阴性的新生儿需行手术治疗的例数。结果脉搏血氧仪组完成随访4 277例,确诊先天性心脏病514例,其中筛查阳性407例,假阴性107例;体格检查组完成随访3 827例,确诊先天性心脏病663例,其中筛查阳性299例,假阴性364例。单纯房间隔缺损、房间隔缺损+动脉导管未闭、单纯动脉导管未闭脉搏血氧仪组筛查阳性率高于体格检查组,差异有统计学意义(P<0.05)。脉搏血氧仪组敏感度79.2%,特异度85.6%,阳性预测值42.9%,阴性预测值96.8%。体格检查组敏感度45.1%,特异度83.2%,阳性预测值35.9%,阴性预测值87.8%。两组筛查结果为假阴性的新生儿需行手术治疗的比例差异无统计学意义(2/107比4/364,P>0.05)。结论应用脉搏血氧仪筛查先天性心脏病简单方便、准确性高。Objective To investigate the effectiveness of pulse oximetry for the screening of congenital heart disease. Methods From 2010.01 to 2013.12, newborn infants without cyanosis from the Neonatal Department of Zhongshan People＇s Hospital were randomly divided into two groups： Pulse Oximetry （PO） group and Clinical Examination （CE） group. In the PO group, congenital heart disease was screened by measuring the SpO2 with pulse oximetry. In the CE group, congenital heart disease was screened by clinical examination. The sensitivity, specificity, positive predictive value and negative predictive value were calculated in both groups. The corrective surgery rate in newborns infants, which were screened as false negative, was recorded in both groups. Results In the PO group, 4 277 patients were followed over time, 514 infants were diagnosed as having congenital heart disease, 407 infants were screened as positive, and 107 infants had false negative screening. In the CE group, 3 827 patients were followed over time, 663 infants were diagnosed as having congenital heart disease, 299 infants were screened as positive, and 364 infants had false negative screening. The positive screening rate was higher in the PO group than in the CE group for the infants with atrial septal defect only, atrial septal defect ＋ patent duetus arteriosus, and patent ductus arteriosus only （P 〈 0.05 ）. In the PO group, the sensitivity, specificity, positiv predictive value and negative predictive value were 79.2%, 85.6%, 42. 9% and 96.8% respectively. In the CE group, the sensitivity, specificity, positive predictive value and negative predictive value were 45.1%, 83.2%, 35.9% and 87.8% respectively. Corrected surgery rate in newborn infants with false negative result was similar between the two groups （2/107 vs. 4/364, P 〉 0. 05）. Conclusions Pulse oximetry screening is simple, convenient and effective for detecting congenital heart disease in newborn infants.

关 键 词：脉搏血氧测定法 心脏病 先天性 筛查 婴儿 新生 

分 类 号：R722.1[医药卫生—儿科]