摘要
目的·探讨经皮氧饱和度测定结合心脏超声远程会诊在偏远地区新生儿危重型先天性心脏病(critical congenital heart disease,CCHD)筛查及转诊中的价值。方法·以上海崇明区2014—2016年的活产新生儿为筛检对象,于生后24～48 h进行经皮氧饱和度测定筛检CCHD,同时按照先天性心脏病分段诊断方法录制标准切面,将心脏超声图像通过微信平台远程会诊后进行初步确诊。结果·共4 450例活产新生儿接受筛检,阳性11例,经心脏超声远程会诊初步确诊CCHD 6例,筛检阴性者中1例后经心脏超声诊断为肺动脉闭锁伴室间隔缺损。经皮氧饱和度筛检CCHD的敏感度为85.71%,特异度为99.89%,假阳性率为0.11%,假阴性率为14.29%,ROC曲线下面积为0.928。结论·经皮氧饱和度测定可以有效筛查出CCHD,结合微信平台心脏超声远程会诊可以初步确诊CCHD,既可及时转诊,又可避免不必要的转诊。该筛查模式简便易行,在缺少先天性心脏病诊治专业医技人员的偏远地区有实用价值。
Objective · To investigate the value of percutaneous oxygen saturation measurement combined with echocardiography remote consultation in the screening and referral of neonatal critical congenital heart disease （CCHD） in remote areas. Methods · The live newborns who were born between 2014 and 2016 in Chongming District of Shanghai were taken as the objects of study, the percutaneous oxygen saturation was measured at 24-48 h after birth. The data were classifed according to congenital heart disease segmental diagnosis standard in the mean time, and the echocardiography was preliminary diagnosed after the remote consultation through WeChat platform. Results · A total of 4 450 live newborns were screened, 11 cases were positive, 6 cases were preliminary diagnosed as CCHD by the echocardiography remote consultation, and 1 case of negative screening was later diagnosed as pulmonary atresia with ventricular septal defect by echocardiography. The sensitivity of percutaneous oxygen saturation screening for CCHD was 85.71%, the specifcity was 99.89%, the false positive rate was 0.11%, the false negative rate was 14.29%, and the area under the ROC curve was 0.928. Conclusion · CCHD can be screened out effectively by percutaneous oxygen saturation combined with the WeChat platform, and it can be preliminary diagnosed by the echocardiography remote consultation, which can provide timely referral and avoid unnecessary referral. This screening model is simple and practical. It has practical value in remote areas where are lack of professional medical technicians for the diagnosis and treatment of congenital heart disease.
作者
沈奕
赵莉晴
刘晓青
郁燕
刘岚
武育蓉
SHEN Yi;ZHAO Li-qing;LIU Xiao-qing;YU Yan;LIU Lan;WU Yu-rong(Department of Paediatrics,Xinhua Hospital Chongming Branch,Shanghai Jiao Tong University School of Medicine,Shanghai 202150,China;Department of Pediatric Cardiovascular,Xinhua Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)
出处
《上海交通大学学报（医学版）》
CAS
CSCD
北大核心
2018年第11期1349-1354,共6页
Journal of Shanghai Jiao tong University:Medical Science
基金
2011年新华医院重点扶植学科
上海交通大学医工交叉项目(YG2015MS70)~~
关键词
先天性心脏病
氧饱和度
筛查
心脏超声
远程会诊
congenital heart disease
oxygen saturation
screening
echocardiography
remote consultation
