摘要目的：比较心脏杂音及经皮脉搏血氧饱和度( SpO2)在新生儿先天性心脏病( CHD)筛查中的重要性,探讨简易可行的CHD筛查方法。方法对2011年5月1日至2013年4月30日常州妇幼保健院出生的16070名新生儿进行CHD筛查,于出生后进行心脏杂音及SpO2的筛查,分为单纯杂音组、单纯SpO2异常组及混合组,对筛查阳性患儿做心脏超声心动图确诊CHD,比较SpO2及心脏杂音在CHD筛查中的重要性。结果16070名新生儿中,男8799例,女7271例,男女比例为1.21：1.00。筛查阳性病例118例,其中单纯杂音组76例,确诊45例；单纯 SpO2异常组28例,确诊18例；混合组14例,确诊13例,确诊率分别为59.21%、64．29%、92.86%。混合组CHD确诊率明显高于其他2组,差异有统计学意义(P=0.045)。 CHD构成类型前3位为室间隔缺损(29/76例,38.16%)、动脉导管未闭(13/76例,17.11%)、房间隔缺损(11/76例,14.48%)。结论联合心脏杂音及SpO2测定两种筛查手段,能提高CHD检出率,减少漏诊率。

abstractsObjective To compare the importance of heart murmurs and transcutaneous oxygen saturation (SpO2)in screening neonatal congenital heart diseases(CHD),and to explore a reliable and easy-to-use method for the screening of CHD. Methods All infants (16 070 cases) born in Changzhou Maternal and Child Health Hospital from May 1 st 2011 to April 30 th 2013 were screened of CHD for heart murmurs and SpO2 . The screen-positive infants were divided into 3 groups:heart murmurs group,abnormal SpO2 group and mixed group. All screen-positive infants re-ceived cardiac color ultrasound to make a definite diagnosis of CHD,so as to compare the values of heart murmurs and SpO2 . Results Eight thousand seven hundred and ninety-nine boys and 7 271 girls were screened,in which the ratio was 1. 21:1. 00. One hundred and eighteen infants were screened positive,including 76 murmurs of which 45 were confirmed as CHD,28 with abnormal SpO2 of which 18 were confirmed and 14 mixed of which 13 were confirmed,so the confirmation rates were 59. 21%,64. 29% and 92. 86%,respectively. The diagnostic rate of CHD in mixed group was higher than other 2 groups,which had statistical significance(P=0. 045). The top three formation types of CHD were ventricular septal defect (VSD) (29/76 cases,38. 16%),patent ductus arteriosus (PDA) (13/76 cases, 17. 11%) and atrial septal defect (ASD) (11/76 cases,14. 48%). Conclusions The combination of heart murmurs and SpO2 was useful in increasing detection and decreasing misdiagnosis of CHD.