婴幼儿先天性心脏病筛查的策略和意义

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目的探讨在人群中早期开展先心筛查的策略,为推广普及先心早期防治提供依据。方法采取前瞻性调查方法,根据随机整群抽样的原则抽取全市其中一个区作为研究人群,将该区14个社区随机分为7个实验组社区和7个对照组社区,实验组按照项目制订的统一实验方案接受先心初筛和确诊,对照组按照常规系统管理方法进行先心筛查,通过武汉市妇幼信息系统网络平台收集相关信息。结果实验组与对照组男女性别比例以及母亲年龄均差异无统计学意义(P﹥0.05),实验组先心检出率为6.08‰,对照组为0.71‰,差异有统计学意义(P﹤0.05);实验组确诊8例中3个月龄前诊断有7例占87.5%,9月龄前诊断1例占12.5%;对照组3个月龄前诊断1例。结论本次调查1岁内人群的先心检出率为6.08‰,先心检出率与筛查模式有关,人群先心筛查应与当前新医改政策相结合,开展先心筛查能进一步完善各级妇幼保健机构的功能。 Objective To explore the strategy of early detection of congenital heart disease in the population and provide the basis for popularizing the early prevention of congenital heart disease. Methods A prospective investigation method was used to select one of the city’s districts as a research population according to the principle of random cluster sampling. The 14 communities in the district were randomly divided into seven experimental community groups and seven control community groups. The experimental groups were formulated according to the project Uniform experimental protocol to accept the heart of the early screening and diagnosis, the control group in accordance with the conventional system management method for congenital screening, through the Wuhan MCH Information System network platform to collect relevant information. Results There was no significant difference in sex ratio between males and females and the age of mothers in experimental group and control group (P> 0.05). The detection rate of congenital heart was 6.08 ‰ in experimental group and 0.71 ‰ in control group (P <0.05) ). Among the 8 cases diagnosed in the experimental group, 7 cases were diagnosed before the age of 3 months, accounting for 87.5%. One case before the age of 9 months was diagnosed as 12.5% ​​and the control group was diagnosed as one case before the age of 3 months. Conclusion The detection rate of the first heart rate of the population within 1 year of this survey is 6.08 ‰. The detection rate of the heart rate is related to the screening mode. The crowd heart rate screening should be combined with the current policy of new medical reform. Carrying out the heart rate screening can further Improve the function of MCH institutions at all levels.
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