云南迪庆州高海拔地区新生儿先天性心脏病“双指标”筛查结局分析  

Analysis on "Double-Index" Screening Outcome of Neonatal Congenital Heart Disease in High Altitude Area of Diqing Prefecture of Yunnan Province

作　　者：方佳慧[1] 赖银珍 刘晓梅[1] 黄国英[3] 和嘉明 Fang Jia-hui;Lai Yin-zhen;Liu Xiao-mei;Huang Guo-ying;He Jia-ming(Kunming Children's Hospital,Kunming 650228,Yunnan Province,China;Diqing Tibetan Autonomous Prefecture People's Hospital,Diqing 674499,Yunnan Province,China;Children's Hospital of Fudan University,Shanghai 201102,China)

机构地区：[1]昆明市儿童医院,云南昆明650228 [2]迪庆藏族自治州人民医院,云南迪庆州674499 [3]复旦大学附属儿科医院,上海201102

出　　处：《中国社区医师》2023年第4期100-102,共3页Chinese Community Doctors

基　　金：云南省科技厅科技计划项目(编号:2018DS008)。

摘　　要：探讨云南迪庆州高海拔地区新生儿先天性心脏病“双指标”筛查对临床诊断的有效性。方法:选取2019年1月-2020年6月昆明市儿童医院、复旦大学附属儿科医院和迪庆藏族自治州人民医院产科出生的916例新生儿为研究对象,在出生后6~72 h内进行“双指标”筛查先天性心脏病,并行心脏彩超检查进行明确诊断。结果:本研究共调查916例新生儿,剔除14例筛查指标不全者,共纳入902例。902例新生儿平均孕周(38.44±1.91)周,平均出生体重(3 183.05±545.91)g,平均血氧饱和度(89.42±4.28)%。“双指标”筛查初筛阳性共252例,占筛查总人数的27.9%;其中血氧饱和度异常179例,进行心脏彩超检查确诊先天性心脏病38例,符合率21.2%;心脏杂音≥2级18例,进行心脏彩超检查确诊先天性心脏病17例,符合率94.4%;“双指标”均为异常55例,进行心脏彩超检查确诊先天性心脏病50例,符合率为91.0%;“双指标”筛查漏诊14例先天性心脏病。心脏彩超异常119例,以卵圆孔未闭和房间隔缺损居多,动脉导管未闭的发生率也较高。结论:新生儿先天性心脏病“双指标”筛查有助其早期诊断。Objective:To explore the effectiveness of "double-index" screening for clinical diagnosis of neonatal congenital heart disease in high altitude area of Diqing Prefecture of Yunnan Province.Methods:A total of 916 liveborn newborns who were born in the Obstetrics Department of Kunming Children’s Hospital,Pediatric Hospital Affiliated to Fudan University and People’s Hospital of Diqing Tibetan Autonomous Prefecture from January 2019 to June 2020 were selected as the study subjects."Doubleindex" screening for congenital heart disease was carried out within 6-72 h after birth,and cardiac color Doppler ultrasound was conducted for the definitive diagnosis.Results:The average gestational week of 902 newborns was(38.44±1.91) weeks,the average birth weight was(3 183.05±545.91) g,and the average blood oxygen saturation was(89.42±4.28)%.A total of 252 people were positive in the initial screening of "double-index" screening,accounting for 27.9% of the total number of people surveyed;among them,179 cases had abnormal blood oxygen saturation,and 38 cases were diagnosed as congenital heart disease by cardiac color Doppler ultrasound,with a coincidence rate of 21.2%;18 cases had cardiac murmur ≥ 2 grade,and 17 cases were diagnosed as congenital heart disease by cardiac color Doppler ultrasound,with a coincidence rate of 94.4%;55 cases had an abnormality for "double indexes",and 50 cases were diagnosed as congenital heart disease by cardiac color Doppler ultrasound,with a coincidence rate of 91.0%;14 cases with congenital heart disease were missed by "double-index" screening.There were 119cases with cardiac color Doppler ultrasound abnormalities,most of which were patent foramen ovale and atrial septal defect,and the incidence of patent ductus arteriosus was higher.Conclusion:"Double-index" screening of neonatal congenital heart disease is helpful to improve the early diagnosis of congenital heart disease.

关 键 词：新生儿 先天性心脏病 筛查 高海拔地区 

分 类 号：R722.1[医药卫生—儿科]