重庆乡镇0～3岁儿童先天性心脏病筛查与随访

发布时间：2018-06-13 14:42

  本文选题：先天性心脏病 + 筛查　； 参考：《中国当代儿科杂志》2017年07期

【摘要】：目的筛查重庆乡镇0~3岁儿童先天性心脏病(CHD)的发病情况,随访确诊的CHD患儿,探索适宜于该地区的CHD筛查、诊断、随访体系及筛查指标。方法采取整群抽样法抽取重庆市涪陵区0~3岁乡镇儿童,采用"乡镇-区县-省市"分级的筛查、诊断、评估体系,以"CHD家族史、呼吸困难、青紫、特殊面容、其他先天性畸形、心脏杂音、脉搏血氧饱和度(Sp O295%)"7项指标进行筛查,1项及1项以上筛查指标阳性者行超声心动图检查以明确有无CHD,并评估CHD患儿病情,指导治疗及随访。结果纳入调查10 281例儿童,实际筛查10 005例(应答率97.32%)。175例筛查指标阳性,其中166例行超声心动图检查,确诊CHD 60例(患病率6‰),其中单纯型46例(76.65%),复合型11例(18.33%),复杂型3例(5.00%)。7项单项筛查指标中,心脏杂音诊断CHD的ROC曲线AUC最大;心脏杂音+特殊面容+其他先天畸形联合对诊断CHD的效果最好。对确诊CHD的患儿继续随访、外科或介入治疗,随访6~18个月,10例自然闭合,13例行介入或手术治疗,36例继续随访,1例因其他原因死亡。结论心脏杂音单项指标及其与特殊面容和其他先天畸形联合筛查对于诊断婴幼儿CHD有重要价值。合理运用各项临床筛查指标,采用"乡镇-区县-省市"分级的婴幼儿CHD筛查、诊断和评估体系,有利于重庆地区婴幼儿CHD的早期发现、诊断及治疗。
[Abstract]:Objective to screen the incidence of congenital heart disease (CHD) in 3-year-old children from Chongqing township, and to explore the suitable screening, diagnosis, follow-up system and screening index for CHD. Methods A cluster sampling method was used to select children aged 3 years from 0 to 3 years old in Fuling district of Chongqing. The screening, diagnosis and evaluation system of "township, county, province and city" classification was used. "Family history of CHD, dyspnea, cyanotic color, special face, other congenital malformations" were used. Heart murmur, pulse oxygen saturation and Sp O295.) "7 indexes were screened for one or more screening indexes. Echocardiography was performed to determine whether CHD was present, and to evaluate the condition of CHD, to guide treatment and follow up." Results among 10 281 children, 10 005 cases were screened (the response rate was 97.323.175 cases were positive, 166 cases were examined by echocardiography). 60 cases of CHD were diagnosed (prevalence rate 6 鈥，

本文编号：2014366