胎儿先天性心脏病的发病率及新生儿卵圆孔未闭结局的研究

The study of the incidence of congenital heart disease in fetuses and the rule of Patent foramen closure in neonates

目的探讨煤炭总医院胎儿先天性心脏病的发病率及新生儿卵圆孔未闭的结局。方法随机选取煤炭总医院2014年11月至2016年2月孕周在22-34（24．4±3．5）周的孕妇共176例，孕妇年龄20-40（28．4±3．4）岁；随机选取同期新生儿病例共70例，与上述孕妇胎儿出生后均不重叠。结果在病例收集期间，发现并确定了多例胎儿及新生儿先天性心脏病，这些典型病例包括胎儿完全型心内膜垫缺损、完全型大动脉转位合并房室间隔缺损及肺动脉瓣狭窄、法洛四联症和新生儿的房、室间隔缺损等。经统计煤炭总医院胎儿和新生儿先天性心脏病发病率约为0．4％，与目前国内外公认的发病率相符。出生后24h内存在卵圆孔未闭的新生儿在之后的1年内是有闭合机会的，其中出生后7d内闭合概率更大。即使1年内未闭合也应继续随访，不宜认定为房间隔缺损。结论煤炭总医院胎儿及新生儿先天性心脏病的发病率与国内总体水平相似，处于较高水平，并且疾病谱有其自身的特点。出生后卵圆孔未闭应加强随访，以减少家庭及社会负担。

Objective To investigate the incidence of congenital heart disease in fetuses and the rule of Patent foramen closure in neonates. Methods Included since November 2014 to February 2016, the research ob- jects are 176 cases who have made the establishment of files and rules in the Obstetrics and Gynecology Depart- ment of China Coal General Hospital and have been making prenatal examination. Statistic and analys the Coal General Hospital group 5 weeks gestation fetal heart index of confidence interval. Statistical analysis was performed by measuring the value of 22, 23, 24 gestational age of fetal cardiac indexes, thus the difference between related indicators were explored. After 24 hours after birth, the newborn infants were examined by eehocardiography and the infants with patent foramen were found to carry out regular follow-up. Results In case collection period, found and identified cases of fetal and neonatal congenital heart disease, including the complete type endocardial cushion defect, complete type of great arteries transposition with ventricular septal defect and pulmonary stenosis, ventricular septal defect （VSD） etc. The statistics of fetal and neonatal congenital heart disease incidence rate in the China Coal General Hospital is about 0.4%, consistent with the incidence statistics that both at home and abroad have recognized. 24 hours after birth of patent foramen ovale in neonates after 1 years have closed opportu- nities, which were born within 7 days after the closing of a greater probability. Even if not closed within 1 years should also continue to follow up, should not be identified as atrial septal defect. Conclusion The current inci- dence of China Coal General Hospital of fetal and neonatal congenital heart disease rate is still at a high level. Af-ter the birth of PFO should strengthen follow-up, to reduce the burden on the family and society.