基于认知理论的医务人员对新生儿先天性心脏病筛查认知框架研究

目的:以认知理论为依据构建陕西省部分地区医务工作者对免费新生儿先天性心脏病双指标法筛查技术的认知框架,从自我认知层面把握对该技术的认知情况,进而结合本省自身特点探究并改进实施过程中存在的问题,为实施有针对性的技术培训和健康教育科普措施提供科学依据。方法:采用定性和定量研究相结合的方法,分层随机抽取陕西省不同层次医疗机构从事妇幼工作的医务人员540名作为研究对象,分析医务人员对免费新生儿先天性心脏病双指标法筛查的认知情况。结果:医务人员对免费新生儿先天性心脏病双指标法筛查相关规范了解程度的中位数为39.07% (33.89%~45.55%);筛查关键技术掌握程度的中位数为60.19% (54.44%~66.48%),其中关于筛查开始时间的正确选择占比53.52%,不同专业技术人员对免费新生儿先天性心脏病双指标法筛查认知情况的认知相差较大,组间比较有统计学差异(P Objective: To construct a cognitive framework for the free neonatal congenital heart disease dual-indicator method of screening for medical workers in some areas of Shaanxi Province based on cognitive theory, grasp the cognitive status of the technology from the level of self-perception, and then explore and improve the problems in the implementation process in the light of the characteristics of the province, so as to provide a scientific basis for the implementation of targeted technical training and health education and popularization measures. Methods: Using a combination of qualitative and quantitative research methods, a stratified random sample of 540 medical staff working with mothers and children at different levels of medical institutions in Shaanxi Province was selected to analyze the medical staff’s knowledge of the free neonatal congenital heart disease dual-indicator method of screening. Results: The median level of knowledge of medical staff about the norms related to free neonatal congenital heart disease dual-indicator method of screening was 39.07% (33.89%~45.55%);the median level of mastery of key screening techniques was 60.19% (54.44%~66.48%), with 53.52% correct choices regarding the timing of screening, there was a statistically significant difference in between-group comparisons of knowledge of the free neonatal congenital heart disease dual-indicator method of screening among different professionals and technicians (P < 0.05). Conclusion: At the present stage, the degree of technical mastery of the free neonatal congenital heart disease dual-indicator method of screening and the degree of understanding of the basic specialized knowledge of neonatal congenital heart disease for medical workers in some areas of Shaanxi Province are relatively low, and repeated and intensive training and publicity of the free neonatal congenital heart disease dual-indicator method of screening for medical institutions at all levels should be strengthened.

2021年宁波市新生儿先天性心脏病流行病学调查

目的调查宁波市新生儿先天性心脏病(CHD)的患病率及分型,为完善宁波市新生儿CHD的筛查、诊断和治疗体系提供支持。方法采用双指标筛查和超声心动图检查相结合的方法,对2021年1月1日至12月31日在宁波市10个县市区出生的59390例新生儿进行监测。结果完成双指标筛查登记的58437名新生儿中,有1672例新生儿双指标筛查阳性,筛查阳性率2.86%,完成心脏超声检查3939例,确诊CHD 449例,宁波市新生儿总体CHD患病率为7.6‰。常见的CHD亚型为房间隔缺损(70.16%)、室间隔缺损(50.56%)、动脉导管未闭(48.33%)。双指标筛查阳性新生儿的CHD检出率显著高于双指标筛查阴性新生儿(P<0.05),心脏生理变化占比显著低于双指标筛查阴性新生儿(P<0.05),早期检出占比显著高于双指标筛查阴性新生儿(P<0.05)。结论宁波市新生儿CHD整体患病率较低。双指标筛查是早期筛查新生儿CHD一项经济、可靠且高效的方法。

192893例新生儿先天性心脏病筛查情况分析

目的 通过分析192893例双指标先心病筛查结果,了解杭州市先天性心脏病发生情况,为先天性心脏病防控提供信息及依据。方法 对2020年1月1日至2021年12月31日在杭州市出生的新生儿进行先天性心脏病双指标筛查,对筛查阳性的新生儿进行超声心动图诊断,所有筛查结果以及诊断结果均录入杭州市产时信息系统,对筛查资料进行统计分析。结果 192893例新生儿经监护人知情同意后接受双指标筛查,筛查阳性6269例,占3.25%。双指标筛查阳性病例进行超声心动图检查,5852例异常,确诊2514例。343例双指标筛查阴性病例进一步超声心动图检查,290例异常,确诊123例。结论 双指标筛查是新生儿先天性心脏病有效筛查手段,杭州市新生儿先心病发生率较高,先心病流行形势不容乐观。