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产前诊断复杂先天性心脏病对新生儿和婴儿发病率及死亡率的影响。

Impact of prenatal diagnosis of complex congenital heart disease on neonatal and infant morbidity and mortality.

机构信息

Division of Pediatric Cardiology, Department of Pediatrics, Jackson Memorial Hospital/University of Miami, Miller School of Medicine, Miami, Florida.

出版信息

Prenat Diagn. 2018 Nov;38(12):958-963. doi: 10.1002/pd.5351. Epub 2018 Sep 27.

Abstract

OBJECTIVES

The objective of this study was to analyze the benefits associated with prenatal diagnosis of complex congenital heart disease (CHD) on preoperative morbidity, 30-day and 1-year mortality in this population.

METHOD

This was a retrospective review of patients with complex CHD born at our tertiary care center over a 10-year period. Date analysis using Student t test and chi-square test.

RESULTS

The overall rate of prenatal detection of complex CHD was 68.1%. A steady increase in the number of complex CHD diagnosed prenatally was noted during the study period. The prenatal diagnosis of complex CHD was associated with significant reduction in the incidence of the following preoperative parameters: antibiotic use, mechanical ventilation, inotropic support, hepatic and renal dysfunction, and acidosis. These beneficial effects were more significant in ductal-dependent cardiac anomalies. However, there were no neonatal and infant survival benefits in association with prenatal diagnosis.

CONCLUSION

Prenatal diagnosis of complex CHD leads to improved preoperative morbidity, especially in patients with ductal-dependent cardiac anomalies. No survival benefits were noted with prenatal diagnosis of complex CHD.

摘要

目的

本研究旨在分析产前诊断复杂先天性心脏病(CHD)对该人群术前发病率、30 天和 1 年死亡率的益处。

方法

这是对我们的三级护理中心在 10 年期间出生的患有复杂 CHD 的患者进行的回顾性研究。使用学生 t 检验和卡方检验进行数据分析。

结果

复杂 CHD 的产前检出率总体为 68.1%。在研究期间,产前诊断复杂 CHD 的数量呈稳步增加。产前诊断复杂 CHD 与以下术前参数发生率的显著降低相关:抗生素使用、机械通气、正性肌力支持、肝肾功能障碍和酸中毒。这些有益影响在依赖导管的心脏畸形中更为显著。然而,与产前诊断相关的新生儿和婴儿存活率没有获益。

结论

产前诊断复杂 CHD 可降低术前发病率,尤其是在依赖导管的心脏畸形患者中。产前诊断复杂 CHD 并未带来生存获益。

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