三级医疗机构中先天性心脏病的发病率

Incidence of congenital heart disease in tertiary care hospital.

作者信息

Shah G S, Singh M K, Pandey T R, Kalakheti B K, Bhandari G P

机构信息

Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Science, Dharan, Nepal.

出版信息

Kathmandu Univ Med J (KUMJ). 2008 Jan-Mar;6(1):33-6.

PMID:18604112

Abstract

AIMS AND OBJECTIVES

The present study was under taken to determine the spectrum, clinical profile and outcome of patients with congenital heart disease (CHD) admitted to a tertiary care hospital.

MATERIALS AND METHODS

This is a retrospective, observational hospital based study conducted during January 2006 to December 2006. Out of 14461 admissions, 84 were cases of CHD. Only patients with echocardiographic proof of CHD were included in the study. Detailed clinical and laboratory findings and outcome of all cases were noted in pre-structured formats. Data were entered in MS-excel. Data was analyzed by software SPSS version 10.

RESULTS

The incidence of CHD was 5.8 per 1000 hospitalized patients. Out of 84 CHD cases, 51 were males and 33 females; with a male to female ratio of 1.5:1. CHD presented more frequently during infancy (46 %). Acyanotic heart disease was detected in 58 (69 %) cases while cyanotic heart disease was detected in 26 (31%) cases. Among acyanotic heart disease, ventricular septal defect (VSD) was found in 49 (58.3%), atrial septal defect (ASD) in 4 patients (4.8%), endocardial cushion defect (ECD) in 2 patients (2.4%) and dextrocardia was found in 3 patients (3.6%). Among cyanotic heart disease, Tetralogy of Fallot (TOF) accounted for 13.1%, total anomalous pulmonary venous connection (TAPVC) 3.6%, transposition of great arteries (TGA) with VSD 1.2% and unspecified cases of heart disease was found in 13.1%. VSD and TOF were the most common lesions while other CHD like ASD, dextrocardia, TAPVC, ECD, TGA with VSD were encountered less frequently. The most common clinical presentations were failure to thrive (FTT) and developmental delay (86.9%), breathlessness (69%), lower respiratory tract infection (LRTI) (52%), congestive cardiac failure (CCF) (46%), cyanosis (20.2%), cyanotic spell (9.5%) and infective endocarditis (9.5%). The mortality rate was 20 %.

CONCLUSION

The incidence of CHD was 5.8 per thousand hospitalized children. VSD, TOF were the most common congenital cardiac lesion. VSD was observed either isolated or associated with other lesions like TGA. The mortality rate was 20 %. The mortality usually occurred in those patients complicated with congestive cardiac failure, lower respiratory tract infection and infective endocarditis.

摘要

目的

本研究旨在确定入住三级医院的先天性心脏病（CHD）患者的疾病谱、临床特征及预后。

材料与方法

这是一项基于医院的回顾性观察研究，于2006年1月至2006年12月进行。在14461例住院患者中，84例为CHD患者。本研究仅纳入经超声心动图证实为CHD的患者。所有病例的详细临床和实验室检查结果及预后均以预先设计的格式记录。数据录入MS Excel。数据采用SPSS 10.0软件进行分析。

结果

CHD的发病率为每1000例住院患者中有5.8例。在84例CHD病例中，男性51例，女性33例；男女比例为1.5:1。CHD在婴儿期更为常见（46%）。58例（69%）为非青紫型心脏病，26例（31%）为青紫型心脏病。在非青紫型心脏病中，室间隔缺损（VSD）49例（58.3%），房间隔缺损（ASD）4例（4.8%），心内膜垫缺损（ECD）2例（2.4%），右位心3例（3.6%）。在青紫型心脏病中，法洛四联症（TOF）占13.1%，完全性肺静脉异位连接（TAPVC）占3.6%，大动脉转位（TGA）合并VSD占1.2%，未明确的心脏病病例占13.1%。VSD和TOF是最常见的病变，而其他CHD如ASD、右位心、TAPVC、ECD、TGA合并VSD则较少见。最常见的临床表现为生长发育迟缓（FTT）和发育延迟（86.9%）、呼吸急促（69%）、下呼吸道感染（LRTI）（52%）、充血性心力衰竭（CCF）（46%）、青紫（20.2%）、青紫发作（9.5%）和感染性心内膜炎（9.5%）。死亡率为20%。