ABSTRACT
Objective:To assess the efficacy of the newly constructed system for screening, managing and monitoring congenital heart disease (CHD) in neonates of Hainan Province, thus providing references for a further promotion.Methods:Clinical data of neonatal CHD in Hainan Province from January 1, 2019 to December 31, 2021 were retrospectively analyzed, including screening, diagnosis and treatment, prognosis and follow-up.Relying on Hainan Women and Children′s Medical Center as the leading unit, a neonatal CHD screening, diagnosis, treatment, and monitoring system was established.A dual-indicator method was adopted, that was, screening staffs in Hainan Province performed CHD screening in living neonates by cardiac auscultation and pulse oximetry (POX) within 6-72 h after birth.Echocardiographic examinations for the screened living neonates were performed in the 31 authorized diagnosis institutions.Evaluations, interventions and treatment of living neonates with CHD were performed in 6 authorized tertiary hospitals.Data of screening, diagnosis, evaluation and treatment were filled in, uploaded and managed online through the neonatal CHD screening information management system.The research team of our hospital was responsible for the data management and monitoring.Results:From January 1 st, 2019 to December 31 st, 2021, there were 329 387 living neonates in Hainan Province, and 321 447 (97.59%) were screened for CHD, and the annual screening rate increased year by year.The positive rate of CHD screening was 2.50%(8 032/321 447). The rate of cardiac ultrasound examination within 1 week of CHD positive screening was 94.66%(7 603/8 032). The referral rate of severe CHD was 100.00%(154/154). The overall prevalence of CHD in neonates of Hainan Province was 3.419‰ (1 099/321 447). Atrial septal defect was the most common CHD lesion, with a proportion of 38.40%(422/1 099). The sensitivity of cardiac auscultation, POX and their combination for CHD detection were 69.15%, 33.49% and 91.90%, respectively, and the specificity were 98.36%, 99.43% and 97.81%, respectively.At the initial screening, the ratio of dual-positive of cardiac auscultation and POX in neonates with severe CHD (serious and critical CHD) was significantly higher than that of a single positive indicator ( χ2=36.502, 46.214, respectively; all P<0.001). All neonates with CHD were evaluated.Fifteen neonates with severe CHD died.From 2019 to 2021, the standardized mortality rate of children aged 0-1 years with CHD in Hainan province was 4.67/100 000 (15/321 447). Conclusions:Dual-indicator screening for CHD (cardiac auscultation plus POX) is reliable, non-invasive, and simple, which is conducive to be clinically promoted.Introducing and promoting an appropriate technology for screening, diagnosis, and evaluation of neonatal CHD are extremely significant since they may have contributed to the timely diagnosis and treatment of CHD, especially severe CHD, thus lowering the mortality.
ABSTRACT
Objective Analysis of ultrasound guided percutaneous lung biopsy and ultrasound examina-tion results,to explore the application value of ultrasound in the diagnosis of benign and malignant lung mass. Methods Application of percutaneous biopsy guided by ultrasound in 109 cases by X-ray and CT examination revealed lung mass patients,analysis of biopsy results and ultrasonographic characteristics,biopsy success rate and complication also be observed. Results The experimental group of 109 cases comprised 98 cases of peripheral mass and 9 cases of central mass with pulmonary consolidation ,81 cases of malignant lesions(74.3％),26 cases benign lesions(23.9％),2 cases were falied(1.8％). 107 cases were success at first operation ,and 5 cases had hemoptysis( incidence 3.8％). The echo types of malignant lesions and benign lesions had significant difference(χ2=2.422,P<0.05),but both of them had intersecting. Malignant lesions were larger than benign lesions(t=1.58, P < 0.05),but the size of malignant lesions with benign lesions had intersecting. Patients with malignant lesions had more or abundant flow,patients with benign lesions had none or fewer flow(χ2=8.471,P<0.05). but they also had intersecting. Conclusions Ultrasonography of benign and malignant lesions in peripheral pulmonary mass and central type with consolidation has certain characteristics. Ultrasound guided percutaneous lung biopsy has major value in determining the pathological type of lung mass and it is safe ,reliable and easy to process.
ABSTRACT
Objective Analysis of ultrasound guided percutaneous lung biopsy and ultrasound examina-tion results,to explore the application value of ultrasound in the diagnosis of benign and malignant lung mass. Methods Application of percutaneous biopsy guided by ultrasound in 109 cases by X-ray and CT examination revealed lung mass patients,analysis of biopsy results and ultrasonographic characteristics,biopsy success rate and complication also be observed. Results The experimental group of 109 cases comprised 98 cases of peripheral mass and 9 cases of central mass with pulmonary consolidation ,81 cases of malignant lesions(74.3％),26 cases benign lesions(23.9％),2 cases were falied(1.8％). 107 cases were success at first operation ,and 5 cases had hemoptysis( incidence 3.8％). The echo types of malignant lesions and benign lesions had significant difference(χ2=2.422,P<0.05),but both of them had intersecting. Malignant lesions were larger than benign lesions(t=1.58, P < 0.05),but the size of malignant lesions with benign lesions had intersecting. Patients with malignant lesions had more or abundant flow,patients with benign lesions had none or fewer flow(χ2=8.471,P<0.05). but they also had intersecting. Conclusions Ultrasonography of benign and malignant lesions in peripheral pulmonary mass and central type with consolidation has certain characteristics. Ultrasound guided percutaneous lung biopsy has major value in determining the pathological type of lung mass and it is safe ,reliable and easy to process.