11366例新生儿先天性心脏病筛查和检出情况分析

Analysis of the screening and detection of congenital heart disease in 11366 newborns

目的基于新生儿先天性心脏病(先心病)筛查和检出情况,初步了解广西新生儿先心病的流行病学特点和临床特征。方法采用心脏听诊+脉搏氧饱和度测定双指标法,对在广西南宁市和梧州市共7家医院出生的11366例新生儿行先心病筛查,对筛查阳性的新生儿进一步行心脏彩超检查以确诊,并对确诊先心病的患儿进行3个月的随访。分析先心病的类型构成,并比较不同特征新生儿的先心病检出情况。结果11366例新生儿中有105例筛查阳性,其中94例确诊为先心病,阳性确诊率为89.5%(94/105),先心病检出率为8.27‰(94/11366)。最常见的3种先心病类型依次为室间隔缺损(40例,42.6%)、房间隔缺损(29例,30.9%)、动脉导管未闭(22例,23.4%)。早产儿、低出生体重儿的先心病检出率、动脉导管未闭检出率、房间隔缺损检出率均分别高于足月儿、正常出生体重儿(均P<0.05)。随访3个月后,94例先心病患儿中有25例自然闭合,包括9例动脉导管未闭、9例房间隔缺损和7例室间隔缺损,总自愈率为26.6%。结论广西部分地区的新生儿先心病检出率处于国内平均水平,以室间隔缺损为主要类型,自愈率偏低。采用心脏听诊+脉搏氧饱和度测定进行先心病筛查,有助于早期发现先心病和及早干预。

Objective To initially understand the epidemiological features and clinical characteristics of Guangxi newborns with congenital heart disease based on the screening and detection of congenital heart disease.Methods A total of 11366 newborns who born at the 7 hospitals in total in Nanning or Wuzhou,Guangxi were screened for congenital heart disease using dual-indexes method of cardiac auscultation+pulse oximetry.The newborns screened as positive were confirmed by cardiac ultrasound examination,and the newborns confirmed with congenital heart disease were followed up for 3 months.The composition of congenital heart disease types was analyzed,and the detection of congenital heart disease was compared between the newborns with different features.Results A total of 105 of 11366 newborns were screened as positive,among which 94 cases were confirmed with congenital heart disease,and the positive confirmatory rate was 89.5%(94/105),as well as the detective rate of congenital heart disease was 8.27‰(94/11366).The 3 common types of congenital heart disease listed as follows:ventricular septal defect(40 cases,42.6%),atrial septal defect(29 cases,30.9%),and patent ductus arteriosus(22 cases,23.4%).The premature infants and low-birth-weight infants exhibited higher detective rates of congenital heart disease,patent ductus arteriosus,and atrial septal defect as compared with the term infants and the normal-birth-weight infants(all P<0.05).After 3 months of follow-up,25 of 94 children with congenital heart disease interpreted in natural closure,including 9 cases of patent ductus arteriosus,9 cases of atrial septal defect,and 7 cases of ventricular septal defect,and the total self-healing rate was 26.6%.Conclusion The detective rate of the newborns with congenital heart disease in some areas of Guangxi is at the domestic average.Ventricular septal defect is the main type,and the self-healing rate is on the low side.Taking cardiac auscultation+pulse oximetry to conduct congenital heart disease screening is beneficial to the early detection for congenital heart disease and the early intervention.