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目的探讨脉搏氧饱和度(SPO2)检测在高原地区先天性心脏病(CHD)新生儿早期筛查中的意义。方法在本院妇产科因高危妊娠、窒息、黄疸、早产等原因会诊的新生儿386例,通过临床查体和SPO2测定,将SPO2≤90%的新生儿进一步行超声心动图、胸片检查,做出补充诊断和治疗。将SPO2≤90%的171例患儿分为轻度缺氧组(SPO2≥86%～90%)和重度缺氧组(SPO2≤85%),比较分析2组CHD患儿的检出率。结果 386例中SPO2≤90%者171例。其中胸片、超声心动图正常者35例,占20%(其SPO2均>86%);诊断肺炎77例,占45%;诊断CHD 59例,占34%,其中PDA 28例,ASD 16例,VSD 5例,法洛四联症、ASD并PDA各3例,肺动脉狭窄2例,完全性大动脉转位、主动脉弓断离各1例。轻度缺氧组48例中诊断CHD 8例,其检出率为16.6%;重度缺氧组123例中诊断CHD 51例,其检出率41.4%,重度缺氧组CHD检出率明显高于轻度缺氧组(P=0.001)。结论 SPO2检测在高原地区新生儿CHD筛查中可作为除体格检查以外的一项重要简便筛查项目,可提高高原地区新生儿CHD的早期诊断率。
Objective To investigate the significance of pulse oxygen saturation (SPO2) detection in early screening of newborns with congenital heart disease (CHD) in the plateau area. Methods In our hospital, 386 newborns were referred for obstetrics and gynecology due to high risk pregnancy, asphyxia, jaundice and premature delivery. The newborns with SPO2 ≤90% were further examined by echocardiography and chest radiography , Make supplementary diagnosis and treatment. 171 children with SPO2≤90% were divided into mild hypoxia group (SPO2≥86% -90%) and severe hypoxia group (SPO2≤85%). The detection rate of the two groups of children with CHD was compared and analyzed. Results Among 386 cases, there were 171 cases with SPO2 ≤90%. Among them, 35 cases were normal chest radiographs and echocardiography, accounting for 20% (SPO2> 86%); 77 cases diagnosed pneumonia (45%); 59 cases diagnosed as CHD (34%), including 28 cases of PDA and 16 cases of ASD 5 cases of VSD, 4 cases of tetralogy of Fallot, 3 cases of ASD and PDA, 2 cases of pulmonary stenosis, complete transposition of aorta and 1 case of disconnection of aortic arch. 48 cases of mild hypoxia diagnosed CHD in 8 cases, the detection rate was 16.6%; severe hypoxia group of 123 cases of CHD diagnosed in 51 cases, the detection rate was 41.4%, severe hypoxia group CHD detection rate was significantly higher In mild hypoxia group (P = 0.001). Conclusion SPO2 detection can be used as an important and simple screening item besides physical examination in neonatal CHD screening in highland areas, which can improve the early diagnosis rate of neonatal CHD in highland area.