Ferreira M, Pinto F, Macedo A, Banazol N, Franco C, Magalhães M P, Lima M
Serviço de Cardiologia Pediátrica, do Hospital de Santa Marta, Lisboa.
Rev Port Cardiol. 1992 Jan;11(1):37-43.
To determine the influence of echocardiography in the preoperative diagnosis of heart diseases in children.
Retrospective study.
Hospitalized children admitted in Departments of Pediatric Cardiology and Cardiothoracic Surgery.
Children of both sexes, aged from neonate to 14 years old, with heart disease who underwent cardiac surgery.
From January 1989 to July 1990, 220 consecutive cardiac surgeries were performed in children with heart disease. The initial diagnosis was based on data from clinical examination, electrocardiogram, thorax X-Ray and echocardiogram (M-mode, 2D, conventional and colour Doppler). Patients were separated in three groups according to their ages: newborn infants less than 28 days old; infants less than 12 months old; children more than 1 year old and less than 14 years old. Patients were separated according to the investigations used further for preoperative diagnosis: whether they had or not cardiac catheterization performed prior to surgery.
From 220 surgical interventions performed, 124 were "open heart" surgeries (9 neonates, 28 infants and 87 children) and the remaining had "closed heart" operations (14 neonates, 37 infants and 45 children). Preoperative diagnosis was mainly dependent on echocardiography, dispensing catheterization in 90 cardiac interventions. The diagnosis was confirmed at surgery or at autopsy. There were 9 deaths, 3 of which occurred in patients not submitted to cardiac catheterization.
Echocardiography is a reliable method for investigation and establishment of the preoperative diagnosis of heart diseases in children. Its use may further reduce the need for diagnostic catheterization in children, particularly in risk groups.
确定超声心动图在儿童心脏病术前诊断中的影响。
回顾性研究。
儿科心脏病学和心胸外科收治的住院儿童。
年龄从新生儿到14岁的患有心脏病且接受心脏手术的儿童。
1989年1月至1990年7月，对220例患有心脏病的儿童连续进行了心脏手术。初始诊断基于临床检查、心电图、胸部X线和超声心动图（M型、二维、传统和彩色多普勒）的数据。根据年龄将患者分为三组：小于28天的新生儿；小于12个月的婴儿；大于1岁且小于14岁的儿童。根据术前诊断进一步使用的检查将患者分开：术前是否进行了心导管检查。
在进行的220例手术中，124例为“心脏直视”手术（9例新生儿、28例婴儿和87例儿童），其余为“非心脏直视”手术（14例新生儿、37例婴儿和45例儿童）。术前诊断主要依赖超声心动图，90例心脏手术无需心导管检查。手术或尸检证实了诊断。有9例死亡，其中3例发生在未进行心导管检查的患者中。
超声心动图是儿童心脏病术前诊断的可靠检查和确立方法。其应用可能进一步减少儿童尤其是高危组患者对诊断性心导管检查的需求。
