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目的研究北京市上地医院1年出生新生儿先心病的流行情况,探索先心病在基层医院筛查和管理方法。方法选择2006年7月1日～2007年6月30日北京市上地医院出生全部新生儿,住院期间每日均予体格检查、详细心脏听诊,出生第二天心电图检查,对有病理性杂音、青紫、气促等不能用呼吸神经等疾病解释及心电图提示先心病者,进一步心脏彩超检查,出院随访6月～1年。结果筛查5 581例,发现听诊异常51例,其中彩超确诊先心病41例,诊断率80.4%,非先心病10例,为瓣膜返流或假腱索;2例新生儿除外心脏外原因青紫、气促,听诊异常,均确诊复杂心脏畸形;EKG提示先心病者4例,均确定诊断;X线诊断右位心2例。心脏彩超确诊先心病43例:室间隔缺损15例,占34.9%;房间隔缺损10例,占23.2%;单纯动脉导管未闭12例,占27.9%;镜像右位心2例,占4.7%;原发性肺动脉高压1例,占2.3%;复杂心脏畸形3例,占7.0%。死亡共4例,占9.3%。结论在基层医院做好新生儿体格检查、心脏听诊,合理选择心脏超声等检查,出院随访半年以上,能够廉价高效地早期发现先天性心脏病并降低婴儿死亡率。
Objective To study the prevalence of neonatal congenital heart disease born in Beijing Shangdi Hospital in one year and explore the screening and management of congenital heart disease in primary hospitals. Methods All the newborns born in Shangdi Hospital of Beijing Municipality from July 1, 2006 to June 30, 2007 were inspected daily for physical examination, detailed auscultation and electrocardiogram examination on the second day of life, , Bruising, shortness of breath and other diseases can not be used to explain the respiratory nerve and ECG prompt congenital heart disease, further examination of cardiac ultrasound, discharged from 6 months to 1 year follow-up. Results A total of 5 581 cases were detected, including 51 cases of abnormal auscultation, of which 41 cases were diagnosed by color Doppler ultrasonography, the diagnosis rate was 80.4%, and 10 cases were non-congenital heart disease, with valvular regurgitation or false chordae; , Shortness of breath, auscultation anomalies, were diagnosed with complex cardiac malformations; EKG prompt congenital heart disease in 4 cases were confirmed diagnosis; X-ray diagnosis of right heart in 2 cases. Forty-three cases of congenital heart disease diagnosed by color Doppler echocardiography: 15 cases of ventricular septal defect (34.9%), 10 cases of atrial septal defect (23.2%), 12 cases of simple patent ductus arteriosus (27.9%), 2 ; 1 case of primary pulmonary hypertension, accounting for 2.3%; 3 cases of complex cardiac malformations, accounting for 7.0%. A total of 4 deaths, accounting for 9.3%. Conclusions Physical examination of the newborn, auscultation of the heart, auscultation of the heart, rational choice of echocardiography and so on were performed in the primary hospitals. After more than six months of follow-up, they were able to detect congenital heart disease early and reduce the infant mortality rate.