10005例0-3岁婴幼儿先天性心脏病筛查结果分析

发布时间：2018-05-24 22:43

  本文选题：先天性心脏病 + 筛查　； 参考：《重庆医科大学》2012年硕士论文

【摘要】：目的：探索农村地区早期发现先心病的适宜筛查及诊断技术，初步建立“乡镇-区县-省市”分级的农村地区儿童先天性心脏病（Congenital Heart Disease，先心病）筛查、诊断和评估体系，分析重庆农村地区先心病发病情况。 方法：在重庆市涪陵区以社区为基本抽样单位，采用整体抽样方法，抽取龙桥、李渡、白涛、江东、江北、崇义、荔枝、墩仁、清溪镇、南沱乡10个街道、乡镇作为筛查单位，被选中社区实际居住人口中，所有0～3岁婴幼儿纳入筛查对象，由受过培训的区级及乡镇儿科医师或儿保医师对筛查对象按“先心病家族史、呼吸困难、青紫、特殊面容、心脏杂音、其他先天性畸形、SpO2＜95%”7项指标进行筛查，填写筛查表，具有1项及1项以上筛查指标阳性者为可疑先心病婴幼儿，对其发放转诊单，以超声心动图为核心诊断技术，由儿科心血管专科医师进行诊断、评估及随访，并对筛查结果进行分析。 结果：1.筛查人数10005例，具有1项及1项以上筛查指标阳性者178例，其中166例行超声心动图检查，诊断先心病60例，先心病患病率6‰，7项筛查指标中，特殊面容（85.71%）、SpO2＜95%（58.33%）的先心病检出率较高，其次为其他先天畸形（55.56%）及心脏杂音（47.41%）。2.经过多因素回归分析，其中心脏杂音、特殊面容2项筛查指标，具有统计学意义（P＜0.05），其OR值(95％可信区间)分别为5.010（1.748~14.359）、10.371（1.114~96.535）。3.各型先心病中，单纯型先心病占76.65%(46/60)，室间隔缺损（单纯及复合缺损）占先心病50%（30/60），房间隔缺损（单纯及复合缺损）占41.67%(25/60)，居前列。 结论：1.初步建立“乡镇-区县-省市”分级的农村地区儿童先心病筛查、诊断和评估体系。2.重庆农村地区儿童先心病患病率约6‰3.7项筛查指标需综合应用，，心脏杂音、特殊面容2项筛查指标对早期发现先心病具有显著意义。4.对婴幼儿进行健康体检及先心病筛查，恰当选择超声心动图检查，儿科心血管医师评估，是早期发现先心病，及时干预，降低婴幼儿先心病并发症及自然病死率的有效方法。
[Abstract]:Objective: to explore the suitable screening and diagnostic techniques for early detection of congenital heart disease in rural areas, and to establish a screening, diagnosis and evaluation system for congenital heart disease in children in rural areas. The incidence of congenital heart disease in rural areas of Chongqing was analyzed. Methods: taking community as the basic sampling unit in Fuling District of Chongqing, the whole sampling method was used to select 10 streets of Longqiao, Li du, Bai Tao, Jiangdong, Jiangbei, Chongyi, litchi, Dun Ren, Qingxi Town, Nantuo Township, and villages and towns as screening units. Of the actual resident population in the selected community, all children aged 0 to 3 years were included in the screening program. Pediatricians or child care doctors who had been trained at district and township levels were selected as having a family history of congenital heart disease, dyspnea, blue and purple, and special features. Seven indexes of SPO _ 2 < 95% of cardiac murmur and other congenital malformations were screened, and the screening form was filled out. The children with one or more of the screening indexes were suspected congenital heart disease. A referral sheet was issued, and the core diagnostic technique was echocardiography. Diagnosis, evaluation and follow-up by pediatric cardiovascular specialist, and analysis of screening results. The result is 1: 1. 10005 cases were screened and 178 cases were positive for one or more screening indexes. Among them, 60 cases were diagnosed by echocardiography, and the prevalence rate of congenital heart disease was 6 鈥

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