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,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,Congenital heart malformation:,Prevalence, severity,survival,and quality of life,先天性心脏病流行病学,1,The lowest values/1000 live births,Author Region,Fyler 2.10 New England, USA,Gardiner 2.17 Toronto, Canada,Akman 3.20 Bogalusa, USA,MacMahon 3.20 Birmingham, UK,Mckeown 4.20 Birmingham, UK,Bosi 4.60 Italy,Bierman 4.70 Hawaii,Prevalence of congenital heart malformation at birth,2,the highest values/ 1000 births,author Region,Fischer 8.20 Tyrol,Austria,Kerrebijn 8.26 Leiden , Netherland,Grech 8.80 Malta,Hoffmann 8.82 San Francisco, USA,Meberg 9.02 Norway,Nakazawa 10.00 Japan,Manetti 12.30 Florence, Italy,Yerushalmi 11.70 California,USA,Prevalence of congenital heart malformation at birth,3,The oldest surveys/ 1000 live births,Author Date Prevalence (),Macmahon 194049 3.23,Carlgren 1941 50 6.35,Harris 194450 5.90,Pleydell 194457 3.20,Landtman 1945 63 8.00,Richards 194653 5.50,Gardiner 194849 2.17,Mustachi 194951 5.88,Prevalence of congenital heart malformation at birth,4,Recent data / 1000 live births,Author Date Prevalence(),Grech 1990-94 8.80,Robida 1984-94 12.23,Bosi 1992-93 4.60,Anderson 1987-90 10.20,Cerboni 1988-90 6.08,Ferencz 1981-89 4.23,Pexieder 1986-87 6.04,Meberg 1982-88 9.02,Prevalence of congenital heart malformation at birth,5,Prevalence of congenital heart malformation at birth,Regional differences/ 1000 live births,Region Mean Range difference place,Europe 6.67 3.20 Birmingham, UK,12.30 Florence, Italy,USA 5.76 3.20 Bogalusa,8.56 San Francisco,Canada 3.97 2.17 Toronto,5.54 Alberta,Other countries 8.97 6.08 Guadeloupe,6,Yearly fluctuation in Bohemian data,from 1980 through 1989,Year No. of malformation Prevalence/ 1000,646 7.04,547 6.39,568 6.77,1983 548 6.73,566 6.97,495 6.16,436 5.53,455 5.82,402 5.11,367 4.80,Prevalence of congenital heart malformation at birth,7,The prevalence was highest in October,and lowest in December ,June and July.,The peak of the prevalence coincided with,the epidemics of influenza in early pregnancy,8 and 9 months previously.,There was a definite seasonal variation,8,Ratio of boys to girls,Boys to girls with CHD: 51.9% to 48.1%,A higher proportion of boys was found with :,DORV (2.68: 1); HLHS (2.25 :1),cTGA ( 2.11 :1);,A higher proportion of girls was found with:,PDA (1 :1.66); Ebsteins malformation (1 :1.57),Common arterial trunk (1:1.22),9,Distribution of congenital heart malformation,VSD 41.59%,ASD 8.67%,Aortic stenosis 7.77%,Pulmonary stenosis 5.81%,cTGA 5.39%,Aortic coarctation 5.29%,PDA 5.07%,Greater than 5% of the overall number of malformation,10,Distribution of congenital heart malformation,AVSD 4.00%,HLHS 3.42%,TOF 3.36%,DORV, common arterial trunk and pulmonary atresia,1.05-1.37%,TAPVC 0.80%,Tricuspid 0.78%,Ebstein malformation 0.44%,Interrupted aortic arch 0.44%,11,Spontaneous closure in 576 of 2092 recognized,ventricular Septal defects,accounting for 27.5% of the cases,12,Critical heart malformation in neonates,10 most frequent Number proportion of total,Malformations number seen(%),cTGA 102 84,Pul atresia 39 74,Coarctation 34 49,HLHS 34 94,Tricuspid atresia 13 77,DORV 20 50,VSD 8 8,Common AT 8 50,TOF 7 28,Critical heart disease: which threaten life,which manifested by,severve Congestive heart failure,deep cyanosis, or both symptoms,13,Death rate of children born with CHD,14,Survival in most frequent cardiac malformation,CHD Number survival (%) at age of,1 5 15yrs,VSD 2097 91 90 89,ASD 436 94 93 93,Aortic stenosis 391 90 89 88,PS 292 96 96 96,cTGA 271 62 56 54,Coarctation 266 68 65 65,PDA 255 91 91 91,AVSD 201 62 55 54,HLHS 172 0 0 0,TOF 169 84 78 77,15,Questionnaires, 1564,例,8-13,岁,先心病患儿生存,质量调查,83.2%,未用任何药,3.2%,体能差,59.5%,可参加娱乐消遣性活动,6.7%,可参加竞争性的运动,35.5%,上学延迟,6.9%,学习差,身高及体重及同龄人无区别,先心病儿给父母造成心理紧张,生活质量,16,
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