Guía J M, Bosch V, Castro F J, Téllez C, Mercader B, Gracián M
Sección de Cardiología Pediátrica. ospital Universitario Virgen de la Arrixaca. Murcia.
Rev Esp Cardiol. 2001 Mar;54(3):299-306.
In the last few years, important progress has taken place in management of congenital heart disease. These changes have had an influence on diagnosis, preoperative management, surgery treatment and postoperative care, giving rise to better results in the treatment of children suffering from congenital heart disease.
To assess the results of congenital heart diseases in a reference hospital by comparing two periods with reference to both diagnosis and therapeutical management. We also intend to investigate the influence that factors such as the existence of extracardiac congenital malformations and heart surgery have on mortality.
Our sample group was made up of 1,216 children suffering from congenital heart disease. Their ages ranged from 1 day to 7 years old. These children were born over a period of thirteen years and studied at the paediatric cardiology unit in a reference hospital in the Autonomous Community of Murcia, a region of Spain. We retrospectively analysed their development by individual heart diseases (and their associated factors), and the global results. Our research was divided into two periods: between 1978 and 1983, and between 1984 and 1990. Differences were found regarding diagnosis and treatment.
a) Mortality rate from congenital heart disease decreased in the period between 1984 and 1990 in comparison to the period between 1978 and 1983, from 28 to 21,7% (p < 0.05); b) individually, the mortality rate decreased with statistical significance in two diseases: interventricular communication and patent ductus arteriosus, and c) there is a higher mortality rate of patients with no surgery treatment and/or extracardiac malformations.
Progress in the management of congenital heart disease has led to a more favourable outcome in the last years.
在过去几年中，先天性心脏病的管理取得了重要进展。这些变化对诊断、术前管理、手术治疗和术后护理产生了影响，从而在先天性心脏病患儿的治疗中取得了更好的效果。
通过比较两个时期在诊断和治疗管理方面的情况，评估一家参考医院中先天性心脏病的治疗结果。我们还打算研究心外先天性畸形和心脏手术等因素对死亡率的影响。
我们的样本组由1216名先天性心脏病患儿组成。他们的年龄从1天到7岁不等。这些患儿在13年的时间里出生，并在西班牙穆尔西亚自治区一家参考医院的儿科心脏病科接受研究。我们通过个体心脏病（及其相关因素）和总体结果对他们的病情发展进行了回顾性分析。我们的研究分为两个时期：1978年至1983年，以及1984年至1990年。在诊断和治疗方面发现了差异。
a）与1978年至1983年期间相比，1984年至1990年期间先天性心脏病的死亡率有所下降，从28%降至21.7%（p<0.05）；b）就个体而言，两种疾病的死亡率有统计学意义的下降：室间隔缺损和动脉导管未闭，以及c）未接受手术治疗和/或有心外畸形的患者死亡率更高。
先天性心脏病管理方面的进展在过去几年带来了更有利的结果。
