新生儿青紫型先天性心脏病156例的早期诊治分析

目的 了解青紫型先天性心脏病在新生儿期的临床表现、分布情况、治疗和转归。方法 1999年11月至2004年7月上海儿童医学中心对156例青紫型先天性心脏病(CHD)新生儿进行临床分析。结果 (1)青紫型CHD在新生儿期主要表现为中央性紫绀、心功能不全，个别可合并心律紊乱。(2)新生儿期青紫型CHD以完全性大动脉转位(TGA)居首位，其他依次为肺动脉闭锁(PA)、完全性肺静脉异位引流(TAPVC)和肺动脉狭窄(PS)。(3)内科治疗包括强心、利尿、扩血管药物和前列腺素E1(PGE1)的运用；156例中57例施行外科手术，其中以TGA最多。结论新生儿青紫型CHD心脏畸形复杂，病情多危重，在生后尽早明确诊断并给予适当的内外科治疗有助于提高其生存率和改善预后。 Abstract Objective To investigate the clinical manifestation,distribution,treatment and prognosis of congenital heart disease in neonatal period.Methods Analyze 156 cases of neonatal cyanotic congenital heart disease clinically.Results ① Neonatal cyanotic CHD was manifested with central cyanosis,heart failure,and arrhythmia occasionally.② D TGA stand first on the list of neonatal cyanotic CHD and the others ordinal was PA,TAPVC and PS.③ Internal medical therapy included using of cardiotonic,diuretic and prostaglandin E157 patients were given surgical operations and TGA lead the first.Conclusion For complex anomaly and critical condition in most cases,neonatal cyanotic CHD should be diagnosed as soon as possible and treated appropriately in order to improve the viability and prognosis of these neonates. Key words NeonateHeart disease;Congenital

Early diagnosis and therapy for neonatal cyanotic congental heart disease.

Abstract Objective To investigate the clinical manifestation,distribution,treatment and prognosis of congenital heart disease in neonatal period.Methods Analyze 156 cases of neonatal cyanotic congenital heart disease clinically.Results ① Neonatal cyanotic CHD was manifested with central cyanosis,heart failure,and arrhythmia occasionally.② D TGA stand first on the list of neonatal cyanotic CHD and the others ordinal was PA,TAPVC and PS.③ Internal medical therapy included using of cardiotonic,diuretic and prostaglandin E157 patients were given surgical operations and TGA lead the first.Conclusion For complex anomaly and critical condition in most cases,neonatal cyanotic CHD should be diagnosed as soon as possible and treated appropriately in order to improve the viability and prognosis of these neonates.