新生儿先天性心脏病54例

目的 分析新生儿先天性心脏病(CHD)的临床特点,为早期诊断提供依据.方法 收集本院2005年5月- 2010年8月54例CHD患儿.男31例,女23例；胎龄30～41周；出生体质量1200～3920g.分析CHD患儿的病理类型、病史、临床表现和辅助检查等情况.采用心脏彩色多普勒超声诊断仪探查其左心室长轴、大动脉短轴、四腔心(胸骨旁、心尖、剑突下),必要时胸骨上窝探查其主动脉弓,证实其心血管畸形存在.结果 新生儿非发绀型CHD占75.93％,发绀型占24.07％；非发绀型CHD中病理类型共有8种,其中以ASD、PDA和VSD居多；发绀型CHD病理类型有7种,以大动脉转位和法洛四联症较多.临床表现以发绀、呼吸急促、心脏杂音等最为常见.早产儿发绀型CHD发生率为62.50％,足月儿为7.89％,二者比较差异有统计学意义(P＜0.01).结论 新生儿CHD的临床表现不典型,早期诊断较困难,对可疑病例应引起重视,结合辅助检查尽早诊断.

Clinical Analysis on 54 Cases of Congenital Heart Disease in Newborn Infants

Objective To explore the clinical characteristics of the newborn congenital heart disease(CHD) in order to provide refe-rences for earlier diagnosis.Methods The pathologic type,clinical manifestations and auxiliary examinations of 54 newborn infants with CHD(31 cases were male and 23 cases were female;30-41 weeks old;the weight was 1 200-3 920 g) were analyzed,adopting color doppler ultrasonography was used to detect the left ventricular long axis,aorta short axis,four-chamber heart(parasternal,apical,xiphoid),and if necessary,the aortic arch suprasternal fossa was performed confirm the presence of cardiovascular abnormalities.Results The non-cyanosis CHD accounted for 75.93%,which had 8 pathological types,and most of them were atrial septal defect,patent ductus arteriosus and ventricular septal defect;the cyanosis CHD accounted for 24.07%,which expressed in 7 pathological types,mainly in the form of aorta transition and tetralogy of fallot.Their common clinical manifestations were heart murmur,cyanosis and shortness of breath.Cyanosis CHD incidence rate was 62.50% in premature infants,7.89%in full-term infants,and there was a significant difference between them(P<0.01).Conclusions Clinical manifestations of newborn CHD are not typical and the early diagnosis is difficult,so attention should be paid to the suspected cases,and the diagnosis of CHD should be performed by auxiliary examinations as early as possible.