本文選題：先天性心臟病 + 篩查��； 參考：《重慶醫(yī)科大學(xué)》2012年碩士論文

【摘要】：目的：探索農(nóng)村地區(qū)早期發(fā)現(xiàn)先心病的適宜篩查及診斷技術(shù)，初步建立“鄉(xiāng)鎮(zhèn)-區(qū)縣-省市”分級的農(nóng)村地區(qū)兒童先天性心臟�。–ongenital Heart Disease，先心�。┖Y查、診斷和評估體系，分析重慶農(nóng)村地區(qū)先心病發(fā)病情況。 方法：在重慶市涪陵區(qū)以社區(qū)為基本抽樣單位，采用整體抽樣方法，抽取龍橋、李渡、白濤、江東、江北、崇義、荔枝、墩仁、清溪鎮(zhèn)、南沱鄉(xiāng)10個街道、鄉(xiāng)鎮(zhèn)作為篩查單位，被選中社區(qū)實際居住人口中，所有0～3歲嬰幼兒納入篩查對象，由受過培訓(xùn)的區(qū)級及鄉(xiāng)鎮(zhèn)兒科醫(yī)師或兒保醫(yī)師對篩查對象按“先心病家族史、呼吸困難、青紫、特殊面容、心臟雜音、其他先天性畸形、SpO2＜95%”7項指標(biāo)進(jìn)行篩查，填寫篩查表，具有1項及1項以上篩查指標(biāo)陽性者為可疑先心病嬰幼兒，對其發(fā)放轉(zhuǎn)診單，以超聲心動圖為核心診斷技術(shù)，由兒科心血管�？漆t(yī)師進(jìn)行診斷、評估及隨訪，并對篩查結(jié)果進(jìn)行分析。 結(jié)果：1.篩查人數(shù)10005例，具有1項及1項以上篩查指標(biāo)陽性者178例，其中166例行超聲心動圖檢查，診斷先心病60例，先心病患病率6‰，7項篩查指標(biāo)中，特殊面容（85.71%）、SpO2＜95%（58.33%）的先心病檢出率較高，其次為其他先天畸形（55.56%）及心臟雜音（47.41%）。2.經(jīng)過多因素回歸分析，其中心臟雜音、特殊面容2項篩查指標(biāo)，具有統(tǒng)計學(xué)意義（P＜0.05），其OR值(95％可信區(qū)間)分別為5.010（1.748~14.359）、10.371（1.114~96.535）。3.各型先心病中，單純型先心病占76.65%(46/60)，室間隔缺損（單純及復(fù)合缺損）占先心病50%（30/60），房間隔缺損（單純及復(fù)合缺損）占41.67%(25/60)，居前列。 結(jié)論：1.初步建立“鄉(xiāng)鎮(zhèn)-區(qū)縣-省市”分級的農(nóng)村地區(qū)兒童先心病篩查、診斷和評估體系。2.重慶農(nóng)村地區(qū)兒童先心病患病率約6‰3.7項篩查指標(biāo)需綜合應(yīng)用，，心臟雜音、特殊面容2項篩查指標(biāo)對早期發(fā)現(xiàn)先心病具有顯著意義。4.對嬰幼兒進(jìn)行健康體檢及先心病篩查，恰當(dāng)選擇超聲心動圖檢查，兒科心血管醫(yī)師評估，是早期發(fā)現(xiàn)先心病，及時干預(yù)，降低嬰幼兒先心病并發(fā)癥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

本文編號：1930930