心脏杂音、呼吸困难和经皮氧饱和度测定在新生儿先天性心脏病筛查中的作用

临床儿科杂志 ›› 2014, Vol. 32 ›› Issue (1): 26-29.

心脏杂音、呼吸困难和经皮氧饱和度测定在新生儿先天性心脏病筛查中的作用

胡煜¹ 余静¹ 管利荣¹ 李卓娅² 郑小兰¹ 吴晓芳¹ 王小双¹

1. 绵阳市中心医院儿科； 2. 绵阳市人民医院儿科（四川绵阳　621000）

收稿日期:2013-06-30 出版日期:2014-01-15 发布日期:2014-01-15

Value of heart murmurs, dyspnea and transcutaneous oxygen satuation in screening for neonatal congenital heart diseases HU Yu¹, YU Jing¹, GUAN Lirong¹, LI Zhuoya², ZHENG Xiaolan¹, WU Xiaofang¹, WANG Xiaoshuang¹ (1.Department of Pediatrics, Mianyang Central Hospital; 2.Department of Pediatrics, Mianyang City People's Hos-pital , Mianyang 621000, Sichuan, China)

Received:2013-06-30 Published:2014-01-15 Online:2014-01-15

摘要/Abstract

摘要：

　目的　探讨可靠和易推广的新生儿先天性心脏病筛查方法。方法　选择2012年1至12月分娩的新生儿5 350例，以彩色超声心动图检查为金标准，评估心脏杂音、呼吸困难和经皮氧饱和度（SpO₂）异常在先天性心脏病筛查中的真实性、可靠性和收益。结果　分别以心脏杂音、呼吸困难和经皮SpO₂单独作为先心病的筛查指标，其灵敏度和特异度为29.03%~81.71%，可靠性为39.10%~81.35%，收益率为1.49%~99.37%；以心脏杂音合并呼吸困难、心脏杂音合并SpO₂异常、呼吸困难合并SpO₂异常各两项，以及同时存在心脏杂音、呼吸困难、SpO₂异常三项进行筛查，其较单项筛查指标的灵敏度下降，特异度升高，可靠性和收益有所提高。结论　联合心脏杂音、呼吸困难和SpO₂异常指标，在新生儿先天性心脏病筛查中有一定临床应用和推广价值。

Abstract: 　Objective 　To explore a more reliable and easy-to-use method for the screening of neonatal congenital heart diseases (CHD). Methods Totally 5 350 newborns delivered from January 2012 to December 2012 were involved in this study. All participants received cardiac color ultrasound to make a definite diagnosis which was used to evaluate the validity, reliability and benefit ratio of such indicators as heart murmur, dyspnea and transcutaneous oxygen satuation (SpO₂)<95% in the screening of neonatal CHD. Results The sensitivity and specificity were in the range of 29.03% to 81.71%, reliability was 39.10% to 81.35%, and benefit ratio was 1.49% to 99.37% when heart murmur, dyspnea and abnormal SpO₂ were used separately as the screening indicators for CHD. When their combination such as heart murmurs plus dyspnea, heart murmurs plus abnormal SpO₂, dyspnea plus abnormal SpO₂, and heart murmurs plus dyspnea plus abnormal SpO₂ were used for screening, the sensitivity was decreased, while the specificity, reliability and benefit ratio were increased. Conclusions The combination of heart murmur, dyspnea and abnormal SpO₂ is useful in the screening of neonatal congenital heart disease.

胡煜余静管利荣李卓娅郑小兰吴晓芳王小双. 心脏杂音、呼吸困难和经皮氧饱和度测定在新生儿先天性心脏病筛查中的作用[J]. 临床儿科杂志, 2014, 32(1): 26-29.

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