佛山市新生儿房间隔缺损的筛查分析

The Screening for Neonates Atrial Septal Defect in Foshan Area

目的了解新生儿房间隔缺损(ASD)的患病率及自发性闭合率,并探讨其诊断标准。方法对2007年1月～2009年12月在佛山市妇幼保健院出生1～7天的17330例新生儿进行心脏彩色多普勒超声心动图检查,并对可疑或明确诊断为ASD的病例于出院后继续随访观察3～6个月。结果 17330例新生儿中,房间隔回声中断7816例(占45.1%)。其中,房间隔缺口≤5mm者7724例(占98.82%),其自发性闭合率为73.01%;房间隔缺口>5mm者92例(占1.18%),自发性闭合率为21.35%。结论新生儿ASD的患病率及直径≤5mm的自发性闭合率均较高。对房间隔缺口>5mm,断端回声增强,有彩流穿过房间隔并探及湍流频谱者,可诊断为ASD。

Objective To understand the prevalence of Atrial Septal Defect（ASD） in neonates and their natural course rate,and study the diagnosis standards of ASD in neonates.Methods From January 2007 to December 2009,17 330 neonates borne in Foshan Maternal and Child Health Care Hospital who were 1 to 7 days old were examined by color Doppler ultrasound cardiogram.Identified or doubtful ASD cases were follow-up for three to six months.Results There were 7 816 cases of echo interruption of atrial septum in the 17 330 cases of neonates（occupied 45.1%）.Of 7 816 cases,7 724 cases（occupied 98.82%） with a diameter of defect less or equal to 5 mm,their spontaneous closure rate was 73.01%.92 case（1.18%） with a diameter of detect larger than 5 mm,and their spontaneous closure rate was 21.35%.Conclusion The prevalence of ASD in newborns and spontaneous closure rate of the ASD with a diameter of less than 5 mm are higher.We propose that ASD of neonates can be diagnosed when finding the diameter of ASD larger than 5 mm,the echo of breaking point increasing and color fluid crossing atrial septum.