新生儿期先天性心脏病患儿的临床特征分析  

Clinical Characteristics of Congenital Heart Defect in Neonates

作　　者：胡小龙 陈晓[1] 程鹏[1] 李德元[1] 张小华 HU Xiaoong;CHEN Xiao;CHENG Peng;LI Deyuan;ZHANG Xiaohua(Department of Neonatology,The First Affiliated Hospital of Nanchang University,Nanchang 330006,China;Jiangxi Provin-cial Children′s Hospital,Nanchang 330006,China)

机构地区：[1]南昌大学第一附属医院新生儿科,南昌330006 [2]江西省儿童医院,南昌330006

出　　处：《岭南心血管病杂志》2024年第1期45-50,共6页South China Journal of Cardiovascular Diseases

摘　　要：目的 了解新生儿期先天性心脏病(congenital heart disease, CHD)患儿的临床特点,为临床早期诊治提供依据。方法 本研究为单中心回顾性研究,对南昌大学第一附属医院2016年1月1日至2021年8月31日收治且经超声心动图确诊为CHD的新生儿的临床资料进行分析。结果 297例确诊为CHD的新生儿中,男婴148例(49.83%),出生体质量为(2 617±741)g;足月儿121例(40.74%),早产儿144例(48.49%),过期产儿32例(10.78%);试管婴儿21例(7.07%),双胎46例(15.49%);低出生体质量儿140例(51.85%),出生窒息55例(18.51%)。经皮血氧饱和度低于90%的患儿54例(18.18%);发绀21例(7.07%);闻及杂音58例(19.52%),杂音多见于室间隔缺损。非发绀型CHD明显多于发绀型;非发绀型CHD构成比依次为房间隔缺损、动脉导管未闭和室间隔缺损。申请超声心动图检查的指征中孕母有流产史及妊娠期糖尿病最为常见。不同类别的非发绀型CHD患儿血气分析、心肌酶谱及凝血功能无明显差异。291例非发绀型CHD患儿均在抗感染、营养心脏及输血等治疗后好转出院。6例发绀型CHD有5例放弃治疗后死亡,1例转至他院行手术治疗。结论 新生儿CHD以非发绀型最为常见,房间隔缺损占比较高。当孕母存在导致胎儿CHD的高危因素或新生儿有早产、心脏杂音、血氧下降及发绀等情况时应及时安排超声心动图检查及早诊断。轻型的左向右分流CHD患儿予抗感染、营养支持等治疗即可,对于危重CHD新生儿应迅速转移到设备齐全、技术力量强的小儿心脏中心进行救治。Objectives To investigate the clinical characteristics of congenital heart disease(CHD)in neonates and pro-vided evidence for early diagnosis and treatment.Methods This study is a single center retrospective study,which ana-lyzes the clinical data of newborns admitted to the First Affiliated Hospital of Nanchang University from January 1,2016 to August 31,2021 and diagnosed as CHD by cardiac ultrasound.Results Among the 297 newborns diagnosed with CHD,there were 148 male infants(49.83%)with a birth weight of(2617±741)g;121 full-term infants(40.74%),144 premature infants(48.49%),and 32 expired infants(10.78%);21 cases of in vitro fertilization(7.07%)and 46 cases of twins(15.49%);140 low birth weight(51.85%),55 cases of birth asphyxia(18.51%).Fifty-four children(18.18%)with percutaneous oxygen saturation below 90%;21 cases(7.07%)had cyanosis;58 cases(19.52%)had heard murmurs,which were mostly found in ventricular septal defect.Non cyanotic CHD was significantly higher than cyanotic CHD.The constituent ratios of non cyanotic CHD were atrial septal defect,patent ductus arteriosus and ventricular septal defect in turn.The most common indications for applying for cardiac ultrasound examination were that the pregnant mother hasd a history of abortion and diabetes during pregnancy.There were no significant differences in blood gas analy-sis,myocardial enzyme,and coagulation function among different categories of non cyanotic CHD children.The 291 cases of non cyanotic CHD improved and were discharged after treatment with anti infection,cardiac nutrition,and blood trans-fusion.Five out of 6 cases of cyanotic CHD died after giving up treatment,and 1 case was transferred to another hospital for surgical treatment.Conclusions Non cyanotic CHD is the most common type in neonates,and atrial septal defect accounts for a high proportion.When the pregnant mother has high-risk factors that can lead to fetal CHD or the newborn has premature birth,heart murmur,decreased blood oxygen,and cyanosis,timely arrangement of cardiac ultraso

关 键 词：先天性心脏病 新生儿 治疗 

分 类 号：R541.1[医药卫生—心血管疾病]