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使用脉搏血氧测定筛查新生儿危重先天性心脏病

Author
Matt Oster, MD, MPH
Section Editors
David R Fulton, MD
Leonard E Weisman, MD
Deputy Editor
Carrie Armsby, MD, MPH
Translators
徐发林, 主任医师

引言

先天性心脏病(congenital heart disease,CHD)是新生儿最常见的先天性疾病[1-3]。危重CHD定义为出生后1年内需要手术或导管介入治疗的CHD(表 1)，在CHD中约占25%[4]。虽然许多危重CHD新生儿出生后不久即出现症状并被发现，但仍有一些患儿直至从出生医院出院后才得到诊断[5-8]。对于有危重心脏病变的婴儿，如果延迟诊断且未能及时转诊至在治疗此类患者方面有专业技术的三级医疗中心会增加并发症和死亡的风险[9-11]。

本文将总结应用脉搏血氧测定筛查新生儿危重CHD。危重CHD的表现及具体心脏病的处理将单独讨论。 (参见“识别危重先天性心脏病新生儿”和“新生儿紫绀的心源性病因”和“新生儿紫绀型心脏病的诊断和初始处理”)

定义及目标病变

危重CHD是指出生后1年内需要手术或导管介入治疗的病变(表 1)。该类别包括：导管依赖性病变、紫绀型病变以及不依赖于动脉导管未闭(patent ductus arteriosus, PDA)的不太严重的CHD类型。危重CHD约占所有CHD的25%。

脉搏血氧测定筛查的目标CHD病变包括通常是下列2种的缺陷：a)出生后1年内需要干预；b)有时或大多数时间存在低氧血症[12,13]。包括但不限于下列疾病：

●左心发育不良综合征(hypoplastic left heart syndrome, HLHS)(图 1) (参见“左心发育不良综合征”)

                    

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Literature review current through: 2017-06 . | This topic last updated: 2017-03-10.
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