Laohaprasitiporn Duangmanee, Jiarakamolchuen Tipawan, Chanthong Prakul, Durongpisitkul Kritvikrom, Soongswang Jarupim, Nana Apichart
Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2005 Nov;88 Suppl 8:S163-8.
Congenital heart disease (CHD) is the most common form of cardiovascular diseases in children. In Thailand, there has not been available information about congenital heart disease in neonates. Between January 1st and December 31st, 2000, all full-term babies born at Siriraj Hospital with detected heart murmur within the first week of life were consulted to pediatric cardiologists. Echocardiography was performed for diagnosis in every baby. Total livebirths during that period were 11,245 cases. Heart murmurs were detected in 83 cases. The incidence of heart murmur within the first week of life was 7.38:1,000 livebirths. Innocent murmurs were found in 34 cases and echocardiogram revealed no detectable cardiac anomalies (2 cases), mild tricuspid regurgitation (2 cases), physiologic branch pulmonary stenosis (4 cases), and small size PDA (< 2 mm., 26 cases). Forty-nine cases had CHDs. The incidence of CHD was 4.36:1,000 livebirths. At the time of initial diagnosis, 22 cases (44.8%) were asymptomatic. Among these patients, 1 case had serious cardiac anomaly, i.e., tetralogy of Fallot. There were 27 cases with symptoms, including 15 cases (30.6%) with tachypnea, 8 cases (16.4%) with cyanosis and 4 cases (8.2%) with congestive heart failure. The 3 most common cardiac diseases were ventricular septal defect (9 cases, 18.4%), patent ductus arteriosus greater than 2 mm. (8 cases, 16.3%), and atrial septal defect (8 cases, 16.3%). Those with CHDs were treated with anticongestive medications (22 cases, 44.8%), prostaglandin E1 (5 cases, 10.2%), laser pulmonary vulvulotomy (1 case, 2%), palliative surgery within the first week of life (4 cases, 8.2%) and corrective surgery (4 cases, 8.2%). During follow-up for the period of 1 year, 2 cases died from sepsis. Early diagnosis and proper management are important to reduce morbidity and mortality in the newborn with CHD.
先天性心脏病（CHD）是儿童心血管疾病中最常见的形式。在泰国，尚无关于新生儿先天性心脏病的可用信息。2000年1月1日至12月31日期间，所有在诗里拉吉医院出生、出生后第一周内被检测出心脏杂音的足月婴儿都被转诊给儿科心脏病专家。对每个婴儿都进行了超声心动图检查以进行诊断。该期间的总活产数为11245例。检测到83例心脏杂音。出生后第一周内心脏杂音的发生率为7.38：1000活产。发现34例为无害杂音，超声心动图显示无明显心脏异常（2例）、轻度三尖瓣反流（2例）、生理性分支肺动脉狭窄（4例）以及小型动脉导管未闭（<2mm，26例）。49例患有先天性心脏病。先天性心脏病的发生率为4.36：1000活产。在初次诊断时，22例（44.8%）无症状。在这些患者中，1例有严重心脏异常，即法洛四联症。有27例有症状，包括15例（30.6%）呼吸急促、8例（16.4%）发绀和4例（8.2%）充血性心力衰竭。3种最常见的心脏病是室间隔缺损（9例，18.4%）、大于2mm的动脉导管未闭（8例，16.3%）和房间隔缺损（8例，16.3%）。患有先天性心脏病的患者接受了抗充血药物治疗（22例，44.8%）、前列腺素E1治疗（5例，10.2%）、激光肺血管造口术（1例，2%）以及出生后第一周内的姑息性手术（4例，8.2%）和矫正手术（4例，8.2%）。在1年的随访期间，2例死于败血症。早期诊断和适当管理对于降低先天性心脏病新生儿的发病率和死亡率很重要。
