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目的调查东莞市6~13岁不同户籍学龄儿童先天性心脏病的患病率及诊疗状况,为东莞市学龄儿童先心病防治策略的制定提供依据。方法采用心脏听诊结合现场心脏彩超检查的方法,对东莞市2011年11月-2012年11月期间所有在读小学生进行先天性心脏病筛检和问卷调查及诊疗状况分析。结果共筛检540 574名小学生,其中本地户籍儿童214 634名(39.7%),外地户籍儿童325 940名(60.3%)。先天性心脏病总患病率为2.14‰,本地户籍和外地户籍儿童患病率分别为1.97‰和2.26‰,两者差异无统计学意义(P>0.05)。筛检前已治率在本地和外地户籍儿童分别为63.51%和47.21%(P<0.05)。在542例需要进一步治疗的患儿中,本地和外地户籍患儿各为154和388例,分别占各自总患者数的36.49%和52.79%(P<0.05)。结论东莞市本地户籍与外地户籍学龄儿童先天性心脏病患病率无明显差异,与国内外报道的相同。年龄横断面先天性心脏病患病率亦无明显差异。但外地户籍患儿的治疗率明显低于本地户籍患儿,提示对大量外来人口子女先心病的诊疗有待进一步加强,以免延误治疗时机。
Objective To investigate the prevalence and diagnosis and treatment of congenital heart disease in 6 ~ 13-year-old school-age children in Dongguan City, and to provide basis for the development of prevention and control strategies for congenital heart disease in school-age children in Dongguan. Methods Auscultation of the heart combined with on-site echocardiography was used to screen all the primary school students who were undergraduates from November 2011 to November 2012 in Dongguan City. The questionnaires and the status of diagnosis and treatment of congenital heart disease were analyzed. Results A total of 540 574 pupils were screened, of whom 214 634 were registered children (39.7%) and 325 940 (60.3%) were registered children. The total prevalence of congenital heart disease was 2.14 ‰. The prevalence rates of local and foreign registered children were 1.97 ‰ and 2.26 ‰, respectively, with no significant difference (P> 0.05). The rate of pre-screening treatment was 63.51% and 47.21% respectively (P <0.05). Among 542 children who needed further treatment, 154 and 388 children, both local and overseas, accounted for 36.49% and 52.79% of their respective total number of patients (P <0.05). Conclusion There is no significant difference in the prevalence of congenital heart disease between the local and permanent registered permanent residents in Dongguan City, which is the same as that reported at home and abroad. There was no significant difference in the prevalence of congenital heart disease in the cross section of age. However, the treatment rate of foreign registered children was significantly lower than that of local registered children, suggesting that the diagnosis and treatment of congenital heart disease among a large number of foreign population needs to be further strengthened so as not to delay the timing of treatment.