先天性心脏病筛查、诊疗、监测网络建设体会

摘要

目的:通过在北京地区开展“建立先天性心脏病(先心病)筛查、治疗和监测网络”的研究,使先心病能够得到早发现、早治疗,从而降低北京市出生缺陷率及婴儿病死率.方法:2007年至2012年,由我院小儿心脏中心牵头,依托北京市妇幼机构成熟的行政管理网络,构建先心病监测网络,对北京地区6家妇幼保健院超声医师进行先心病知识、胎儿及新生儿超声心动图技术培训,并对成果进行技术推广,对于特殊病例通过“绿色通道”转诊及时救治.同期开展母婴数据直报,了解先心病的发病及转诊情况.结果:①基层医生先心病筛查和预防水平显著提高,②2007年至2009年,6个区县对17 721例孕妇进行的产前筛查,复杂先心病产前检出率达到91％,复杂先心病引产率97％,在后续6个医疗单位技术推广中,对1 249例孕妇完成产前先心病筛查,复杂先心病产前超声诊断率85.7％；③使北京18个区县先心病筛查技术的覆盖率达80％.结论:先心病筛查、诊疗、监测网络平台建设的实行,能够有效的提高先心病的筛查率,降低出生缺陷率和婴儿病死率,有望成为政府管理预防出生缺陷的有力手段.%Objective:Through carrying out "building congenital heart disease (CHD) screening,treatment and monitoring network" research in the Beijing area,letting CHD get early detection and early treatment,thereby reducing the rate of birth defects and infant mortality in Beijing.Methods:2007-2012,Our hospital pediatric cardiac center as the lead unit,Relying on administrative network of the Beijing mature bodies of women and children,and build a monitoring network of CHD,and physician knowledge of CHD,fetal and neonatal echocardiographic technology training were given to all echo doctors from six secondary maternal & child health centers in Beijing,and promotion the results of technology,timely treatment through the "green channel" referral for special cases.At same period to carry out the direct reporting of maternal and child data to understand the congenital heart disease morbidity and referral.Results:1.Primary care physicians with CHD screening and prevention standards have markedly improved; 2.2007-2009,6 counties of the 17 721 cases of pregnant women prenatal screening,prenatal screening of complex CHD rate reached 91％,97％ of complex CHD induction rate,in subsequent technology promotion,a total of 1 249 cases of pregnant women prenatal congenital heart diseasescreening,prenatal ultrasound diagnosis of complex CHD rate of 85.7％; 3.CHD screening technology makes the 18 districts in Beijing has reached 80％ coverage.Conclusion:The implementation of CHD screening,diagnosis and treatment,and the monitoring network platform,which can effectively improve the rate of CHD screening and reduce the rate of birth defects and infant mortality,is expected to become the powerful tools for the prevention of birth defects in government management.