新生儿室间隔缺损的随访研究  

Investigation of follow-up for neonatal ventricular septal defect

作　　者：张继珍 ZHANG Ji-zhen(Department of Pediatrics,Maternal and Child Health Care Hospital,Xicheng District,Beijing 100054,China)

机构地区：[1]北京市西城区妇幼保健院儿科,北京100054

出　　处：《发育医学电子杂志》2018年第2期95-98,共4页Journal of Developmental Medicine (Electronic Version)

摘　　要：目的对新生儿室间隔缺损进行随访,探讨其类型及预后。方法 2010年7月至2014年1月,北京市西城区妇幼保健院对2 023例新生儿于生后0~7天进行了心脏彩超筛查,共检测出室间隔缺损46例;生后3个月随访时发现2例。每3个月随访1次,至患儿1~4岁。采用χ~2检验进行统计分析。结果产前检测出胎儿室间隔缺损8例,其中1例引产,3例生后复查未发现缺损,4例生后复查仍有室间隔缺损。其余新生儿0~7天检出室间隔缺损42例,生后3个月随访时又发现2例。48例患儿中,肌部室间隔缺损37例(77.1%,37/48),膜部10例(20.8%,10/48),干下型1例(2.1%,1/48)。1例失访,自然闭合39例(83.0%,39/47),手术5例(10.6%,5/41),未闭合2例(4.3%,2/47),死亡1例(2.1%,1/47)。肌部室间隔缺损的自然闭合率高于膜部[94.4%(34/36)与50.0%(5/10),χ~2=5.773,P﹤0.05]。缺损﹤5 mm者的自然闭合率高于缺损≥5 mm者[90.2%(37/41)与33.3%(2/6),χ~2=5.695,P﹤0.05],手术率低于缺损≥5 mm者[4.88%(2/41)与50.0%(3/6),χ~2=4.857,P﹤0.05]。结论肌部及小室间隔缺损自然闭合率高,膜部及大室间隔缺损的自然闭合率低,应重视随访,适时手术。Objective To investigate the type and prognosis of ventricular septal defect in neonates.Methods From July 2010 to January 2014,2 023 newborns in Maternal and Child Health Care Hospital,Xicheng District,Beijing were screened at 0-7 days after birth.46 cases of ventricular septal defect were found,and 2 cases were found at 3 months after birth.The patients were followed up trimonthly to 1-4 years old.The statistical analysis was carried out byχ2 test.Results 8 cases of fetal ventricular septal defect were detected in prenatal period.Among the 8 cases,1 cases underwent induced labor;3 cases did not find defects after birth;and 4 cases had ventricular septal defect after birth.There were 42 cases of ventricular septal defect to be found in other neonates on 0-7 days.2 cases were found when followed up at 3 months after birth.In the 48 children,37 cases were muscular ventricular septal defect(77.1%,37/48),10 cases were membranous part(20.8%,10/48),and 1 case was supracristal ventricular septal defects(2.1%,1/48).One case lost follow-up,39 cases(83%,39/47)were naturally closed,5 cases(10.6%,5/41)were operated,2 cases(4.3%,2/47)were not closed,one case(2.1%,1/47)died.The rate of spontaneous closure of muscular ventricular septal defect was higher than that of membranous[94.4%(34/36)vs 50%(5/10),χ2=5.773,P﹤0.05].The rate of spontaneous closure of the defect less than 5 mm group was higher than that of the defect more than 5 mm group[90.2%(37/41)vs 33.3%(2/6),χ2=5.695,P﹤0.05],and the operation rate was lower than that of the defect more than 5 mm group[4.88%(2/41)and 50%(3/6),χ2=4.857,P﹤0.05].Conclusion The spontaneous closure rate of muscular and small ventricular septal defect is high,and that of membranous and large ventricular septal defect is low.We should pay attention to follow up and operating time.

关 键 词：新生儿 室间隔缺损 随访 自然闭合 

分 类 号：R722.1[医药卫生—儿科]