Sadoh Wilson E, Uzodimma Chinyere C, Daniels Queennette
Department of Child Health, University of Benin Teaching Hospital, Benin Nigeria.
World J Pediatr Congenit Heart Surg. 2013 Apr;4(2):172-6. doi: 10.1177/2150135112474026.
Congenital heart disease (CHD) is among the leading causes of morbidity and mortality in childhood. We report on the spectrum of echocardiographically diagnosed CHD from three different centers across Nigeria.
Over a period of 42 months, children who were referred for echocardiographic evaluation in the centers located in three large metropolitan cities were consecutively recruited if they were confirmed to have identifiable CHD. Data were collected on age, gender, and types of CHD and analyzed using SPSS 16 (Chicago, Illinois,).
A total of 605 children were recruited, their mean age was 2.1 ± 3.5 (range 0-17) years, and 296 (48.9%) were males. Nearly half (42.5%) had echocardiographic diagnosis of their CHD within the first year of life. Only 17% of the diagnoses were made in the neonatal age group. Acyanotic CHDs were more common than the cyanotic heart diseases (82.8% vs 17.2%). The most common CHD was ventricular septal defect (VSD; 46.6%) followed by patent ductus arteriosus (12.1%), atrial septal defect (8.7%), atrioventricular septal defect (8.2%), and tetralogy of Fallot (7.8%). More than half of the VSDs were perimembranous (55.1%) followed by outlet VSD (23.8%), muscular (10.7%), and inlet VSD (9.6%). Only 42 (6.9%) of the entire study population had definitive intervention.
The VSD is the most prevalent CHD in Nigerian children. There is increasing awareness, availability, and use of diagnostic facilities as mirrored in the age distribution of the children. However, access to definitive surgery is poor and draws attention to the urgent need for affordable surgical facilities in the country.
先天性心脏病(CHD)是儿童发病和死亡的主要原因之一。我们报告了尼日利亚三个不同中心经超声心动图诊断的CHD谱。
在42个月的时间里,连续招募了在位于三个大城市的中心接受超声心动图评估的儿童,前提是他们被确诊患有可识别的CHD。收集了年龄、性别和CHD类型的数据,并使用SPSS 16(伊利诺伊州芝加哥)进行分析。
共招募了605名儿童,他们的平均年龄为2.1±3.5(范围0 - 17)岁,其中296名(48.9%)为男性。近一半(42.5%)的儿童在出生后第一年内通过超声心动图诊断出CHD。仅17%的诊断是在新生儿年龄组做出的。非青紫型CHD比青紫型心脏病更常见(82.8%对17.2%)。最常见的CHD是室间隔缺损(VSD;46.6%),其次是动脉导管未闭(12.1%)、房间隔缺损(8.7%)、房室间隔缺损(8.2%)和法洛四联症(7.8%)。超过一半的VSD是膜周部的(55.1%),其次是干下型VSD(23.8%)、肌部(10.7%)和流入道VSD(9.6%)。整个研究人群中只有42名(6.9%)接受了确定性干预。
VSD是尼日利亚儿童中最常见的CHD。正如儿童年龄分布所反映的那样,对诊断设施的认识、可及性和使用正在增加。然而,获得确定性手术的机会很差,这凸显了该国迫切需要负担得起的手术设施。