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目的探讨新生儿重症监护病房(NICU)收治早产儿的心血管病变情况及超声心动图检查的临床应用价值。方法对2010年1～7月收入我院NICU的早产儿行床边超声心动图检查,同时对临床资料进行分析。结果纳入研究早产儿共497例,超声心动图检查未见异常45例(9.0%),非青紫型分流以卵圆孔未闭常见(147例,29.6%);非青紫型先天性心脏病(简称“先心病”)以房间隔缺损为主(48例,9.7%),其次为室间隔缺损(10例,2.0%);青紫型先心病以完全性肺静脉异位引流(4例,0.8%)、法洛氏四联症(2例,0.4%)、肺动脉闭锁(1例,0.2%)为主。其他超声检查异常219例,三尖瓣返流最常见,其中单纯轻度三尖瓣返流54例(10.9%),其次为轻度肺动脉压力增高,单纯轻度肺动脉压力增高18例(3.6%)。先心病早产儿临床表现以呼吸急促、青紫、喂养困难为主。结论新生儿先心病临床表现多样,对入住NICU的早产儿应常规行床边心脏超声,对先心病早期筛查诊断、避免漏诊误诊具有重要价值。
Objective To investigate the cardiovascular status of neonatal intensive care unit (NICU) admitted to premature infants and the clinical value of echocardiography. Methods The bedside echocardiography was performed on preterm infants admitted to NICU in our hospital from January to July in 2010, and the clinical data were analyzed. Results A total of 497 preterm infants were included in the study. No echocardiography was found in 45 cases (9.0%). Non-purple type shunt was common in patients with patent foramen ovale (147 cases, 29.6%), non-purple type congenital heart disease (48 cases, 9.7%), followed by ventricular septal defect (10 cases, 2.0%); cyanotic congenital heart disease with complete pulmonary venous drainage (4 cases, 0.8%), tetralogy of Fallot (2 cases, 0.4%) and pulmonary atresia (1 case, 0.2%). Among the other 219 cases, abnormal tricuspid regurgitation was the most common. Among them, simple mild tricuspid regurgitation was found in 54 (10.9%), followed by mild pulmonary hypertension (mild pulmonary hypertension, mild pulmonary hypertension in 18 cases (3.6% ). Premature children with congenital heart disease clinical manifestations of shortness of breath, bruising, feeding-based. Conclusions The clinical manifestations of neonatal CHD are diverse. Bedside echocardiography should be routinely performed in NICU premature infants. It is of great value in the early screening diagnosis of CHD and avoiding misdiagnosis.