危重先天性心脏病患儿出院前漏诊分析和评估

Evaluation of false negative rate among children with critical congenital heart disease before discharge

目的评估危重先天性心脏病(CCHD)新生儿出院前漏诊率和不同类型CCHD的漏诊情况。方法收集我院2016年2月至2018年2月首次诊治的CCHD患儿560例,分析患儿出院前漏诊率、出生后42d漏诊情况,及不同疾病类型患儿漏诊率情况。结果560例CCHD患儿中出院前漏诊率为19.5%(109/560);患儿病症比例最高的4类CCHD分别为完全性肺静脉异位连接(TAPVC)25.9%(145/560)、单心室(SV)21.8%(122/560)、肺动脉闭锁/室间隔缺损(PA/VSD)17.3%(97/560)、大动脉转位/室间隔缺损(TGA/VSD)15.2%(85/560)。结论新生儿中CCHD的漏诊率较高,尤其需要加强筛查易漏诊的病患类型,为临床治疗提供理论支持。

Objective To evaluate the false negative rate of all kinds of critical congenital heart disease (CCHD) among neonates before discharge. Methods A total of 560 neonates with CCHD who were treated in our hospital from February 2016 to February 2018 were included in the study. The false negative rate of different types of CCHD before discharge and 42 days after birth were recorded. Results Among the 560 cases, the rate of CCHD before discharge was 19.5%(109/560), and TAPVC was 25.9%(145/560), SV was 21.8%(122/560), PA/VSD was 17.3%(97/560), TGA/VSD was 15.2%(85/560). Conclusion Due to high false negative rate of CCHD among neonates, it is necessary to strengthen screening, especially for the types of CCHD with higher false negative rate, to provide support for clinical treatment.