648例新生儿先天性心脏病筛查与随访的研究

Screening and follow-up of congenital heart disease in neonates:a study of 648 cases

目的统计新生儿先天性心脏病(Congenital heart disease,CHD)的发病情况,分析CFD的筛查与随访结果。方法依据CHD家族史、孕早期感染史、发绀、心脏杂音、其他畸形作为筛查指标,对31835例新生儿进行CHD筛查;统计各种类型CHD的构成比及发生率,定期随访评估。结果筛查确诊648例CHD新生儿,CHD类型构成比前3位是:室间隔缺损(21.91%)、房间隔缺损合并室间隔缺损(17.44%)、房间隔缺损(14.20%);死亡率较高的前3位是:复杂型CHD(45.24%)、其它特殊类型CHD(23.81%)、法洛氏四联症(15.79%);随访的3年内,确诊CHD病例数逐年增加,手术例数有逐年增加的趋势,死亡率有逐年降低的趋势,均差异有统计学意义(P<0.05)。结论新生儿先天性心脏病筛查及随访,有利于早期发现和及时干预、治疗CHD,降低死亡率,提高CHD患儿的生存率和治愈率。

Objective To examine the pathogenesis of congenital heart disease（CHD） in neonates so as to inform the screening and follow-up.Method 31835 neonates were firstly screened for CHD by referring to family history of congenital heart disease,mother early pregnancy infection,cyanosis,heart murmur,and other types of malformation as indicators of screening.The percentage of each type of CHD and incidence ratio were then documented and regular followup evaluation was conducted.Findings The screening determined 648 cases of neonatal CHD.The top three types of CHD were ventricular septal defect（21.91%）,atrial septal with ventricular septal defect（17.44%）,and atrial septal defects（14.20%）.The top three types of CHD that lead to mortality are sticklebacks CHD（45.24%）,other special types of CHD（23.81%）,and Rockwell quadruple disease（15.79%）.3-year follow-up found that neonates diagnosed as cases of CHD and the number of neonates as cases of CHD receiving surgery also increased,and death rate dropped.Conclusion Screening and follow-up can be conducive to early diagnosis,timely intervention and treatment of CHD in neonates,reduce mortality,improve survival rate and enhance curing rate.