發(fā)布時間：2018-06-13 14:42

  本文選題：先天性心臟病 + 篩查�。� 參考：《中國當(dāng)代兒科雜志》2017年07期

【摘要】：目的篩查重慶鄉(xiāng)鎮(zhèn)0~3歲兒童先天性心臟病(CHD)的發(fā)病情況,隨訪確診的CHD患兒,探索適宜于該地區(qū)的CHD篩查、診斷、隨訪體系及篩查指標(biāo)。方法采取整群抽樣法抽取重慶市涪陵區(qū)0~3歲鄉(xiāng)鎮(zhèn)兒童,采用"鄉(xiāng)鎮(zhèn)-區(qū)縣-省市"分級的篩查、診斷、評估體系,以"CHD家族史、呼吸困難、青紫、特殊面容、其他先天性畸形、心臟雜音、脈搏血氧飽和度(Sp O295%)"7項指標(biāo)進行篩查,1項及1項以上篩查指標(biāo)陽性者行超聲心動圖檢查以明確有無CHD,并評估CHD患兒病情,指導(dǎo)治療及隨訪。結(jié)果納入調(diào)查10 281例兒童,實際篩查10 005例(應(yīng)答率97.32%)。175例篩查指標(biāo)陽性,其中166例行超聲心動圖檢查,確診CHD 60例(患病率6‰),其中單純型46例(76.65%),復(fù)合型11例(18.33%),復(fù)雜型3例(5.00%)。7項單項篩查指標(biāo)中,心臟雜音診斷CHD的ROC曲線AUC最大;心臟雜音+特殊面容+其他先天畸形聯(lián)合對診斷CHD的效果最好。對確診CHD的患兒繼續(xù)隨訪、外科或介入治療,隨訪6~18個月,10例自然閉合,13例行介入或手術(shù)治療,36例繼續(xù)隨訪,1例因其他原因死亡。結(jié)論心臟雜音單項指標(biāo)及其與特殊面容和其他先天畸形聯(lián)合篩查對于診斷嬰幼兒CHD有重要價值。合理運用各項臨床篩查指標(biāo),采用"鄉(xiāng)鎮(zhèn)-區(qū)縣-省市"分級的嬰幼兒CHD篩查、診斷和評估體系,有利于重慶地區(qū)嬰幼兒CHD的早期發(fā)現(xiàn)、診斷及治療。
[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，

本文編號：2014366