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目的探讨超声心动图对新生儿先天性心脏病(CHD)临床筛查的应用价值。方法对本院2010年1月-2011年12月出生的330例疑似CHD新生儿的心脏超声心动图筛查结果进行分析,应用心脏彩超对新生儿经胸行多切面扫查,了解心脏及大血管位置关系、内径比例,测量房室大小、室壁厚度、运动幅度,测量心功能。观察瓣膜厚度、活动度、房室间隔是否完整。测量瓣口血流速度,观察瓣口有无返流,心腔及大血管间是否存在分流。结果 330例新生儿中单纯卵圆孔未闭96例(29.0%),单纯PDA 45例(13.6%)。CHD 116例(35.1%),其中单纯VSD 16例(13.8%),VSD并卵圆孔未闭15例(12.9%),单纯ASD 13例(11.2%),ASD并卵圆孔未闭13例(11.2%),ASD并VSD 8例(6.9%),ASD并VSD并卵圆孔未闭7例(6.0%),ASD并PDA 17例(14.7%),法洛四联症14例(4.2%),完全性心内膜垫缺损6例(1.8%),右心室双出口3例(0.9%),大动脉转位、三尖瓣下移畸形各2例(各占0.6%)。结论新生儿期较为多见的心内分流为卵圆孔未闭,其与PDA在未来均有闭合的可能。目前绝大多数常见的CHD可通过超声检查得到确诊,可取代大部分心导管检查和心血管造影对于CHD的诊断。
Objective To investigate the value of echocardiography in the clinical screening of neonatal congenital heart disease (CHD). Methods The echocardiographic results of 330 echocardiographically suspected CHD newborns born in our hospital from January 2010 to December 2011 were analyzed. Echocardiography was used to scan the multifaceted section of newborns through the thorax to understand the changes of heart and large Vascular location, diameter ratio, measurement of atrioventricular size, wall thickness, range of motion, measurement of cardiac function. Observed the valve thickness, activity, atrioventricular septum is complete. The velocities of the valve orifice were measured to observe whether the valve orifice had reflux or not and whether there was a shunt between the cardiac cavity and the large blood vessel. Results Among 330 newborn infants, 96 cases (29.0%) had simple patent foramen ovale and 45 cases (13.6%) had simple PDA. There were 116 cases of CHD (35.1%), 16 cases of VSD (13.8%), 15 cases of VSD with patent foramen ovale (12.9%), 13 cases of simple ASD (11.2%), 13 cases of ASD with patent foramen ovale ASD and VSD in 7 cases (6.0%), ASD and PDA in 17 cases (14.7%), tetralogy of Fallot in 14 cases (4.2%), ASD and VSD in 8 cases %), Complete endocardial cushion defect in 6 cases (1.8%), right ventricular double outlet in 3 cases (0.9%), aortic transposition, tricuspid valve deformity in 2 cases (0.6% each). Conclusion The more common intracardiac shunt during the neonatal period is foramen ovale, which may be closed with PDA in the future. Currently the vast majority of CHD can be diagnosed by ultrasound, which can replace most of the cardiac catheterization and cardiovascular angiography for the diagnosis of CHD.