新生儿先天性心脏病的早期诊断及干预

目的提高先心病患儿的生活质量，探索先心病的早期诊断及干预措施。方法对1996年1月至2006年4月在深圳市第七人民医院儿科住院临床疑诊新生儿先天性心脏病患儿42例，全部经彩色多普勒超声心动图检查（部分手术）诊断，早期干预，出院后定期随访。结果42例新生儿先心病中，男22例，女20例。胎龄〈37W5例，37—42W37例。出生体重〈2．5kg6例，2．5—4kg35例，〉4kg1例。入院原因有紫绀26例，咳嗽12例，黄疸7例，窒息5例，气促4例，喂养困难3例，呕吐3例。临床表现中心脏杂音37例，占88％；紫绀26例，占62％；呼吸急促14例，占33％；呼吸暂停1例，占2％；窒息5例，占12％；心衰3例，占5％。先心病类型中非青紫型35例，占83．33％；青紫型37例，占16．67％。结论新生儿先心病部分无症状，病情观察很重要，心脏杂音、紫绀、气促、心衰是早期症状。彩色多普勒超声心动图能早期确诊及判断预后；部分先心病有自然闭合的可能；新生儿科医师不仅要早期诊断先心病，尤其是复杂性青紫型先心病，而且要及时处理合并症及帮助家长选择正确手术时机；依赖动脉导管开放而存活的完全性大动脉错位患儿禁止吸氧。

Studies on early diagnosing and intervention of congenital heart disease in newborns

Objective To evaluate the life quality of patients on congenital heart disease （CHD） in newborns. To investigate early diagnosing and intervention of congenital heart disease in newborns. Methods Inpatients on congenital heart disease in 42 newborns in The 7th People＇s Hospital of Shenzhen from Jan, 1996 to Apr,2006, the suspected eases were finally diagnosed by Color Doppler Eehoeardiography and early treated and were followed - up regularly. Results There were 22 boys and 20 girls of congenital heart disease in newborns. There were 5 pre - term infants and 37 full term infants. There were 6 low birth weight infants and 35 normal birth weight infants, 1 high birth weight infant. Hospitalized causes had 26 eases of eyanosis, 12cases of cough ,7 eases of jaundice ,5eases of asphyxia , 4cases of short of breath ,3cases of feed difficulty , 3 eases of vomit. Among 42 newborns , 35 was found with CHD, 83.33% of which was aeyanotie heart disease. 16. 67% of the CHD newborns were cyanotic heart disease. In physical examination, 37 （ 88% ） was found with cardiac murmur, 26（62% ） was found with eyanosis, 14（33% ） was found with short of breath, 1（2% ） was found with apnea, 5（ 12% ） was found with asphyxia, 3（5% ） was found with congestive heart farlure. Conclusion Because part patients of CHD in newborns was no symptom , paying attention to patient＇s condition was very important. The cardiac murmur , eyanosis , short of breath and congestive heart farlure were early symptoms. Color Doppler Eehoeardiography can early diagnosis and predict condition of CHD . The part patients of CHD ean spontaneously elosure . The paediatrieian must not only early diagnosis CHD , especially cyanotic heart diseases, but handle in time complications and select correctly operated time helping parents . Complete transposition of the arteries patients depended on patent duetus arteriosus for existence forbided oxy- gen therapy.