心脏听诊和经皮脉搏血氧饱和度筛查海南省新生儿先天性心脏病的价值

目的 分析心脏听诊和经皮脉搏血氧饱和度(POX)筛查海南省新生儿先天性心脏病(CHD)的价值.方法 选取2020年1月1日-12月31日在海南省17个市县出生的新生儿作为研究对象,新生儿出生后6～72h内进行常规心脏听诊和POX筛查,筛查阳性的新生儿进行超声心动图以确诊CHD.根据筛查结果,将新生儿分为杂音组(单纯心脏...

Value of cardiac auscultation and transcutaneous pulse oxygen saturation in screening of neonatal congenital heart diseases in Hainan Province

Objective To analyze the value of cardiac auscultation and transcutaneous pulse oxygen saturation(POX)in screening of neonatal congenital heart diseases(CHD)in Hainan Province.Methods The neonates born in 17 cities and counties of Hainan Province from January 1 st 2020 to December 31 st 2020 were selected,routine cardiac auscultation and POX screening were performed within 6-72 hours after birth.The positive neonates received ultrasonic cardiography to make a definite diagnosis of CHD.According to screening results,the neonates were divided into cardiac murmur group(positive in cardiac murmur alone),POX group(positive in POX alone),and double positive group(positive in both cardiac murmur and POX).The value of cardiac auscultation and POX in CHD screening was evaluated.Results A total of 117005 neonates were screened,and 2185 neonates were positive,572 neonates were definitely diagnosed as CHD,the incidence rate of CHD was 0.49%.Among 572 neonates diagnosed as CHD,the top three diseases were atrial septal defect(221 cases,38.64%),ventricle septal defect(144 cases,25.17%),and patent ductus arteriosus(87 cases,15.21%).There were 1670 neonates in cardiac murmur group,the sensitivity and specificity of cardiac murmur alone in detection of CHD were 60.31%and 98.86%,respectively.There were 452 neonates in POX group,the sensitivity and specificity of POX alone in detection of CHD were 20.28%and 99.71%,respectively.There were 2185 neonates in double positive group,the sensitivity and specificity of cardiac murmur combined with POX in detection of CHD were 90.56%and 98.57%,respectively.There was statistically significant difference in the detection rate of severe CHD among the three groups(χ²=82.925,P=0.000).Conclusion Cardiac auscultation combined with transcutaneous pulse oxygen saturation can find neonatal CHD early,especially severe CHD,which is helpful to early diagnosis and treatment.