摘要
目的探讨危重先心病规范化筛查-救治模式,降低新生儿、小婴儿死亡率并为政府决策制定提供依据。方法由慈善机构提供资金支持,卫生行政管理部门依据地域特点选定项目实施地点。河北省儿童医院对被选择地区超声医师进行“一对一”专业培训。由后者对当地出生3个月以内新生儿、小婴儿进行无遗漏的先心病筛查。先心病超声筛查按照“先心病十二切面”筛查诊断方法进行。危重先心病患儿由河北省儿童医院心脏外科进行及时外科救治。慈善机构对于贫困先心病家庭给予医保报销之外的资金救助。结果3个试点共筛查新生儿73355例,检出先心病540例,阳性率0.74%。近5年,3个试点新生儿出生和筛查数量无论是总体还是具体到某一县市,均逐年下降,而先心病的筛查阳性率确没有明显下降趋势。5年超声共筛出危重先心病67例,占先心病总检出量的12.4%。40例危重先心病在新生儿或小婴儿期完成手术,其中38例完成治疗。术后随访结果满意。结论近年新生儿出生率逐渐下降,但先心病尤其是危重先心病发病率居高不下。科学地进行先心病筛查,及时发现并积极救治危重先心病是有效降低婴儿死亡率的重要工作。此项工作的顺利完成需要政府、慈善机构和医疗机构密切分工和配合,且意义重大。
Objective To explore the standardized screening and treatment model for critical congenital heart disease(CCHD),thus providing references for formulating medical policy for the government to lower the mortality of newborns and infants.Methods Funded by charitable organizations,the site of this program was determined by the health administrative department according to the geographical characteristics.A one-for-one training of local sonographers in the selected local institutions was performed by Hebei Children's Hospital.Then,the pre-trained local sonographers were responsible for an exhaustive screening congenital heart disease in local newborns and infants born within 3 months.The ultrasound screening of congenital heart disease was conducted based on the diagnostic criteria of 12-sliced congenital heart disease.CCHD cases were timely saved in the Department of Cardiac Surgery of Hebei Children’s Hospital.Financial aid other than medical insurance reimbursement to poor families with congenital heart disease infants was provided by charitable organizations.Results A total of 73,355 newborns in three pilot sites were screened by echocardiography,and 540(0.74%)cases of congenital heart disease were detected.In the past 5 years,the total number and that in one county or city of newborns born and screened in the three pilot sites annually decreased.However,the positive screening rate of congenital heart disease was not significantly reduced.Within the past 5 years,a total of 67 CCHD cases were screened by ultrasound,accounting for 12.4%of all cases of congenital heart disease.Among them,40 congenital heart disease cases were surgically treated during the newborn or infant period,and 38 cases completed the whole process of treatment.Postoperative follow-up showed the acceptable outcome.Conclusion Despite the declining fertility rate,the incidence of congenital heart disease,especially CCHD remains high.Standardized screening and surgical treatment timely for the CCHD is the chief job for reducing the infant mortality.The successful completion of this work requires close division of labor and cooperation between the government,charities and medical institutions,which is of great significance.
作者
姚洁
贺新建
陈娇阳
崔云
张振影
YAO Jie;HE Xinjian;CHEN Jiaoyang(Hebei Children’s Hospital,Hebei,Shijiazhuang 050000,China)
出处
《河北医药》
CAS
2023年第16期2530-2533,共4页
Hebei Medical Journal
基金
河北省重点研发计划项目(编号:192777100D)。
关键词
危重先心病
规范化
筛查
降低
新生儿
小婴儿
死亡率
critical congenital heart disease
standardization
screening
reduce
newborn
baby
mortality rate
