| Objective: Using heart murmur and pulse oximetry(POX)as a screening method and non-invasive echocardiography as a diagnostic tool in order to obtain the epidemiological data of neonatal congenital heart disease(CHD)in qingxiu district,Nanning city,Guangxi.Methods: 6,674 live birth newborns born in the first affiliated hospital of guangxi medical university and the first people’s hospital of nanning city on April31,2018 were screened for CHD,and were screened for heart murmur and POX within 6 hours to 72 hours after birth,and the positive newborns were diagnosed by echocardiography,evaluation and follow-up were performed by pediatric cardiovascular specialists,and the screening data were statistically analyzed.Results: 1.A total of 6674 live newborns were screened,and 66(about 1.0%)were positive for screening,among which 57(86.4%)were positive for heart murmur screening and 14(21.1%)were positive for POX screening.2.Among the66 newborns with positive screening,62 were diagnosed as CHD by echocardiography,with a positive rate of 93.9% and a total detection rate of9.3‰.According to the CHD classification of "simplex,complex and complex",44 cases of simplex CHD accounted for 71.0%,16 cases of complex CHD accounted for 25.8%,and 2 cases of complex CHD accounted for 3.2%.According to the main malformation of CHD,there were 32 cases of atrial septal defect(51.6%),23 cases of ventricular septal defect(37.1%),and 5 cases of patent ductus arteriosus(8.1%).The above three types of CHD accounted for 96.8% of the total.According to different severity of CHD,48 patients(77.5%)in the mild group were PDA,ASD and VSD.In the middle group,there were 11 cases,accounting for 17.7%,with medium or mixed VSD.In the severe group,there were 3 cases,accounting for 4.8%,including 1 case of large VSD(mixed from perimembrane to subcristae,13mm),1 case of pulmonary atresia,and 1 case of pulmonary vein ectopic drainage.Among the 62 cases of congenital heart disease,the proportion of premature infants and children with low birth weight was 37.1%and 33.9%,respectively,higher than that of children without congenital heart disease(10.2% and 8.7%),and the difference was statistically significant.3.Due to the characteristics of growth and development of children,some CHD patients could heal naturally.After 3 months of follow-up,the overall self-healing rate of CHD was 27.4%,of which the highest self-healing rate was 60.0% for patent ductus arteriosus,26.1% for ventricular septal defect and 25.0% for atrial septal defect.During the follow-up,59 children with mild and moderate CHD were in good condition without serious complications.Three children with CHD in severe group recovered well after surgical treatment.Conclusion: 1.The incidence of neonatal congenital heart disease in this study was 9.3‰.The incidence of premature infants and low birth weight infants was higher than that of full-term infants and normal birth weight infants.The first3 CHD were atrial septal defect,ventricular septal defect and patent ductus arteriosus.2.In this study,some mild and moderate congenital heart disease occurred spontaneously after 3 months of follow-up,and the self-healing rate was27.4%.3.Heart murmur combined with percutaneous oxygen saturation is an effective,simple and economical method for congenital heart disease screening. |
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