探讨超声心动图诊断新生儿先天性心脏病的临床价值  

To Investigate the Clinical Value of Echocardiography in Diagnosing Congenital Heart Disease in Neonates

作　　者：韦春妮 WEI Chunni(Department of Ultrasound,The Second Hospital,University of South China,Hengyang 421001,China)

机构地区：[1]南华大学附属第二医院超声科,湖南衡阳421001

出　　处：《中国医药指南》2023年第36期109-112,116,共5页Guide of China Medicine

摘　　要：目的探讨超声心动图诊断新生儿先天性心脏病的临床价值,以评估超声心动图筛查的效用。方法纳入2020年1月至2022年12月入住我院儿科重症监护室并接受超声心动图和320排CT血管造影(CTA)检查的疑似先天性心脏病新生儿120例为研究对象,这些患儿随后因先天性心脏病接受了心脏手术。以手术结果为金标准,比较超声心动图和320排CTA结果的诊断敏感性、特异性、准确性、阳性预测值(PPV)和阴性预测值(NPV)。结果超声心动图显示75例真阳性、34例真阴性、6例假阳性和5个假阴性结果,灵敏度、特异度、PPV、NPV和诊断准确性分别为94.3%、99.4%、97.5%、98.5%和98.4%。在同一手术区域,320排CTA显示真阳性71例,真阴性31例,假阳性9例,假阴性9例,敏感度、特异度、PPV、NPV和诊断准确性分别为89.4%、98.5%、94.2%、97.2%和96.2%。超声心动图诊断准确性高于320排CTA(χ^(2)=6.402,P=0.011),能够更有效且可靠地检测出手术期间发现的心脏缺陷。结论超声心动图和320排CTA是对先天性心脏病患儿诊断准确率高的成像方法,并且超声心动图显示出了更加优越的诊断性能,是诊断先天性心脏病的首选方法。Objective To investigate the clinical value of echocardiography in diagnosing congenital heart disease in neonates,and to evaluate the effectiveness of echocardiography screening.Methods A total of 120 neonates with suspected congenital heart disease who were admitted to the pediatric intensive care unit of our hospital from January 2020 to December 2022 and underwent echocardiography and 320-row CTA examination were included.These patients subsequently underwent heart surgery due to congenital heart disease.The diagnostic sensitivity,specificity,accuracy,positive predictive value(PPV)and negative predictive value(NPV)of ultrasound and 320-row CTA results were compared using surgical results as the gold standard.Results Echocardiography showed 75 true positive,34 true negative,6 false positive and 5 false negative results.The sensitivity,specificity,PPV,NPV and diagnostic accuracy were 94.3%,99.4%,97.5%,98.5%and 98.4%,respectively.In the same surgical area,320-row multilayer spiral 320-row CTA showed true positive in 71 cases,true negative in 31 cases,false positive in 9 cases,and false negative in 9 cases.Sensitivity,specificity,PPV,NPV and diagnostic accuracy were 89.4%,98.5%,94.2%,97.2%and 96.2%,respectively.The diagnostic accuracy of echocardiography was higher than that of 320-row CTA(χ^(2)=6.402,P=0.011),which could more effectively and reliably detect cardiac defects found during surgery.Conclusions Echocardiography and 320-row CTA are imaging methods with high accuracy in the diagnosis of children with congenital heart disease,and echocardiography shows superior diagnostic performance,and is the first choice for the diagnosis of congenital heart disease.

关 键 词：超声心动图 新生儿 先天性心脏病 临床价值 

分 类 号：R445[医药卫生—影像医学与核医学] R541.1[医药卫生—诊断学]