CAJ | 학술논문

目的了解常州市新生儿先天性心脏病(CHD)的流行情况和病例分布特征,并对106例新生儿CHD进行随访分析,为建立符合国情的“新生儿CHD筛查-随访-干预体系”提供依据.方法对2011年5月1日至2013年4月30日常州妇幼保健院出生的16 070例新生儿进行CHD筛查及诊断,对CHD患儿定期随访至1岁.结果 CHD筛查阳性117例,确诊106例,发病率6.60‰;C HD构成类型前3位是室间隔缺损(VSD)(2.18‰,35/16 070例)、动脉导管未闭(PDA)(1.74‰,28/16 070例)、房间隔缺损(ASD)(1.06‰,17/16 070例);其中因发现心脏杂音而确诊81例,动脉氧饱和度异常48例,二者筛查检出率最高.随访97例,失访9例,ASD、PDA、VSD自然闭合率最高,分别为76.47％、64.29％、62.86％.随访中发现缺损大小对CHD自然闭合率有影响,小型VSD、ASD及早产儿PDA闭合率高,而大中型缺损的VSD、ASD及足月儿PDA闭合率低.部分严重CHD及有并发症患儿已手术治疗,其余未愈者仍在随访中.结论本地区新生儿CHD发病率处于国内平均水平,对CHD患儿进行系统随访有助于CHD患儿生存质量的提高,CHD筛查-随访-干预体系是完全可行的.
목적 료해상주시신생인선천성심장병(CHD)적류행정황화병례분포특정,병대106례신생인CHD진행수방분석,위건립부합국정적“신생인CHD사사-수방-간예체계”제공의거.방법 대2011년5월1일지2013년4월30일상주부유보건원출생적16 070례신생인진행CHD사사급진단,대CHD환인정기수방지1세.결과 CHD사사양성117례,학진106례,발병솔6.60‰;C HD구성류형전3위시실간격결손(VSD)(2.18‰,35/16 070례)、동맥도관미폐(PDA)(1.74‰,28/16 070례)、방간격결손(ASD)(1.06‰,17/16 070례);기중인발현심장잡음이학진81례,동맥양포화도이상48례,이자사사검출솔최고.수방97례,실방9례,ASD、PDA、VSD자연폐합솔최고,분별위76.47％、64.29％、62.86％.수방중발현결손대소대CHD자연폐합솔유영향,소형VSD、ASD급조산인PDA폐합솔고,이대중형결손적VSD、ASD급족월인PDA폐합솔저.부분엄중CHD급유병발증환인이수술치료,기여미유자잉재수방중.결론 본지구신생인CHD발병솔처우국내평균수평,대CHD환인진행계통수방유조우CHD환인생존질량적제고,CHD사사-수방-간예체계시완전가행적.
Objective To investigate the prevalence and the distribution of congenital heart disease(CHD) in Changzhou city.The clinical data of 106 CHD infants were reviewed,so as to provide some evidence for making CHD screening-evaluating-intervention system.Methods All infants(16 070 cases) born in Changzhou Maternal and Child Health Hospital from May 1st 2011 to Apr.30th 2013 were screened for CHD.The infants with CHD were followed up for one year periodically after discharge.Results One hundred and seventeen infants were screened positive,and 106 cases of them were diagnosed as CHD,and the detectable rate was 6.60‰.The top three incidence was VSD (2.18‰,35/16 070 cases),PDA(1.74‰,28/16 070 cases) and ASD(1.06‰,17/16 070 cases).Among them,81 cases were detected as cardiac souffle,and 48 cases as abnormal pulse oximetry.In 106 cases,97 cases were followed up and 9 cases did not receive follow-up.The close ratio were higher in ASD,PDA,VSD,which was 76.47％,64.29％,62.86％.The size of gap had an effect on close ratio,small gap of VSD,ASD and premature PDA were higher and medium and large gap and full-term infants were lower.Some serious type of CHD infants received operations,and others were still followed up.Conclusion The detectable rate of CHD among infants was identical to the average level of whole country.The follow-up study may improve the quality of the survival of CHD infants,and it is feasible to construct a system of screening-evaluating-intervention systcm of CHD.