综合医院新生儿先天性心脏病类型分析

THE CATEGORY ANALYSIS OF NEONATAL CONGENITAL HEART DISEASE IN THE SYNTHETICAL HOSPITAL

本文对1987年1月～2001年12月入我院新生儿病房并经多普勒彩色超声心动图或尸体解剖诊断的类型分布。其中非青紫型先心病89例,占74.8％,青紫型30例,占25.2％。新生儿先心病常见类型的构成比依次为室间隔缺损(简称室缺)37.8％,动脉导管未闭26.9％,肺动脉瓣狭窄8.4％,法洛四联症6.7％,继发孔型房间隔缺损(简称房缺)5.9％,大动脉转位5.0％。38例室缺中,缺损直径≤3mm26例,占68.4％,4～5mm10例,≥6mm2例;27例动脉导管未闭中,导管内径2～3mm21例,占77.8％,3.1～4mm6例;7例房缺中,缺损直径5～6mm5例,7～8mm2例。7例发生充血性心力衰竭(简称心衰),占5.9％,其中2例室缺于生后42d和49d死亡。伴随心外畸形6例,占5.0％,结论:综合医院新生儿先心病的类型分布与专科医院不完全相同。新生儿先心病以室缺最多。非青紫型以室缺、动脉导管未闭的小型缺损多见,中型和大型室缺易发生肺炎和心衰,甚至引起死亡。青紫型以肺动脉瓣狭窄、法洛四联症、大动脉转位多见。本组较少伴随心外畸形。

To understanding the category distribution of neonatal congenital heart disease(NCHD) in the synthetical hospital, 119 cases of NCHD in the ward for sick newborn infants from January in 1987 to December in 2001 were analyzed by retrospective study. They were diagnosed by color Doppler echocardiography or autopsy. Results showed 89 cases(74.8% ) belonged to non-cyanotic NCHD, 30 cases(25.2%) belonged to cyanotic NCHD. The common categories of NCHD in proportion were successively 37.8% of ventricular septal defect (VSD), 26.9% of patent ductus arteriosus( PDA), 8.4% of pulmonary stenosis, 6.7% of tetralogy of Fallot, 5.9% of secundum atrial septal defect( ASD), 5.0% of transposition of great arteries. The size of simple defect(diameter): among 38 cases of VSD, 26(68.4%) were ≤3 mm, 10 were4~5 mm, 2 were ≥6 mm; among 27 cases of PDA, 21(77.8%) were ≤2 ~ 3 mm,6 were 3.1 ~ 4 mm; among 7 cases of ASD, 5 cases were 5 ~ 6 mm, 2 was 7 ~ 8 mm. 7 cases(5.9% ), caused congestive heart failure, among them, 2 cases of VSD died at the age of 42 d and 49 d. 6 cases(5.0%) with extracardiac anomalies. 9 m conclusion: the category distribution of NCHD in the synthetical hospital has been not identical with it in the specialized hospital. VSD has been a most common type of NCHD. Small-sized defects of VSD and PDA have been more common types in the non-cyanotic NCHD, middle-sized and large-sized VSD have caused pneumonia and congestive heart failure easily, even death. Pulmonary stenosis, tetralogy of Fallot and transposition of great arteries have been more common types in the cyanotic NCHD. A few babies of NCHD with extracardiac anomalies.