新生儿心脏超声检查：我们的准确性如何？
Neonatal cardiac ultrasound: How accurate are we?
作者信息
Priyadarshi Archana, Klimek Jan
机构信息
Neonatal Intensive Care Unit Westmead Hospital PO Box 533 Wentworthville New South Wales 2145 Australia.
出版信息
Australas J Ultrasound Med. 2017 Apr 26;20(2):66-71. doi: 10.1002/ajum.12048. eCollection 2017 May.
INTRODUCTION
To assess the accuracy of neonatal clinician-performed cardiac ultrasound (CPU) in detection of congenital heart disease (CHD) in newborn infants with no antenatally suspected cardiac abnormality.
METHODS
We reviewed records of all infants diagnosed with CHD, identified all new cases of CHD detected by CPU and classified them as 'severe' or 'other'; the 'severe CHD' was further classified as 'critical' or 'non-critical CHD'. We compared the CPU diagnosis to the final diagnosis as per paediatric cardiologist echocardiography.
RESULTS
A total of 357 infants identified to have any form of CHD; 50 newly diagnosed by neonatal CPU: 21 'severe' and 29 'other' CHD. The neonatologist CPU had a high concordance rate with the final diagnosis. There were three incorrect diagnoses identified by CPU.
CONCLUSION
This audit demonstrates high accuracy, in our unit, of neonatal CPU in identifying new cases of CHD not suspected antenatally. A neonatal CPU could enhance the pickup rate and, with appropriate referral to a paediatric cardiologist, improve the clinical care of infants born with CHD.
引言
评估新生儿临床医生操作的心脏超声（CPU）在检测产前未怀疑有心脏异常的新生儿先天性心脏病（CHD）方面的准确性。
方法
我们回顾了所有被诊断为CHD的婴儿的记录，确定了由CPU检测出的所有CHD新病例，并将其分类为“严重”或“其他”；“严重CHD”进一步分为“危重型”或“非危重型CHD”。我们将CPU诊断结果与儿科心脏病专家超声心动图的最终诊断结果进行了比较。
结果
共识别出357例患有任何形式CHD的婴儿；50例由新生儿CPU新诊断出：21例“严重”CHD和29例“其他”CHD。新生儿科医生的CPU与最终诊断结果具有较高的一致性。CPU识别出3例错误诊断。
结论
本次审核表明，在我们科室，新生儿CPU在识别产前未怀疑的CHD新病例方面具有较高的准确性。新生儿CPU可以提高检出率，并通过适当转诊至儿科心脏病专家，改善患有CHD婴儿的临床护理。
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