经皮脉搏血氧饱和度测定筛查新生儿复杂性先天性心脏病

Screening Newborns for Critical Congenital Heart Disease with Pulse Oximetry

目的:探讨经皮脉搏血氧饱和度测定筛查法(POS)筛查新生儿复杂性先天性心脏病(cCHD)的准确性及临床应用可行性。方法:对2011年6-12月在我院分娩或转诊我院的331例新生儿行POS。同时进行心脏超声或CT检查明确先天性心脏病诊断,根据诊断结果分正常新生儿组、单纯性心脏病组、cCHD组共三组,例数分别为:125例、86例、120例。对三组的分娩孕周、出生体重、血氧饱和度值(SpO2)进行比较分析。对cCHD的SpO2结果及确诊时段进行分类统计。结果:单纯性先天性心脏病组与正常新生儿组SpO2比较差异无显著性(P>0.05)。cCHD组与正常新生儿组SpO2比较差异有显著性(P<0.05)。产前超声、临床症状及体征联合POS筛查可以减少cCHD漏诊率。结论:POS可作为筛查cCHD的一种辅助手段,同时也是一种简单、易行,无需特殊培训可广泛应用于各级医疗机构的有效cCHD筛查手段。

Objective To explore the accuracy and validity of detecting critical congenital heart disease （cCHD））by Pulse oximetry screening （POS）. Method 331 neonates were monitored by POS and perform echocardiography or computerized tomography （CT） from June 2011 to December 2011. They were divided into 3 groups： the normal group include 125 ease; the mild congenital heart disease group include 86 case; the cCHI） group include 120 case. The gestational age, birth weight and arterial oxygen saturation （Sp02） were compared between the three groups. The SpO2 value and diagnosis time of the eCHD cases were classified and analyzed. Result The premature birth and low birth weight were the high risk factors of mild congenital heart disease. The Sp02 difference between the mild congenital heart disease group and the normal group was no Significant （P 〉 0.05 ）. Significant difference appeared in the SpO2 between the cCHD group and the normal group （P 〈 0.05）. Combining POS and Clinical Examination in screening for eCHD, can play a role in reducing the missing diagno,ais rme. Conclusions POS is simple, practicable and unnecessary for special training, POS can be an effective way to screen eCHD.