【摘要】 目的 探讨“一体化管理”对危重型先天性心脏病（critical congenital heart disease,CCHD）早产儿外科手术治疗及短期预后的影响。方法 本研究为单中心回顾性研究，对广东省人民医院2015年1月1日至2019年12月31日入院接受手术的CCHD早产儿的资料进行分析，根据有无“一体化”管理分为产前诊断组（产前组）与产后诊断组（产后组），对一般资料、手术情况及短期疗效进行组间比较。结果 共纳入49例患儿，产前组29例，产后组20例。总住院病死率为14.3%，不良结局发生率为32.7%，早产儿相关并发症发生率为38.8%；两组患儿总住院病死率、不良结局发生率、相关并发症发生率比较，差异无统计学意义（P>0.05）。产前组中大动脉转位的患儿最多，产后组中完全性肺静脉异位引流患儿最多。产前组患儿入院日龄和手术日龄均小于产后组，差异有统计学意义（分别为P=0.000,P=0.001）。产后组患儿的确诊时间中位数为12.5 d。结论 “一体化管理”模式使CCHD早产儿得到早诊断早治疗，但短期内可能不会降低病死率和不良结局发生率。更多还原

【Abstract】 Objectives To investigate the impact of "integrated management of prenatal diagnosis-postnatal treatment" on the surgical treatment and short-term efficacy of preterm infants with critical congenital heart disease(CCHD).Methods In this single-center retrospective study,data of preterm infants with CCHD admitted for surgical treatment from January 1,2015 to December 31,2019 in Guangdong Provincial People’ s Hospital were analyzed.And the infants were divided into prenatal group and postnatal group according to the availability of "integrated management mode".The general data,surgical treatment and short-term efficacy of the two groups were compared.Results A total of 49 children were included,with 29 cases in prenatal group and 20 cases in postnatal group.The total hospital mortality rate was 14.3%,the incidence of adverse outcomes was 32.7%,and the incidence of prematurity-related morbidity was 38.8%.There were no statistical differences of total hospital mortality rate,incidence of adverse outcomes and incidence of prematurity-related morbidity between the two groups.The prenatal group had the most infants with transposition of the great arteries and the postnatal group had the most infants with total anomalous pulmonary venous connection.Both the age at admission and age at surgery were less in prenatal group than in postnatal group(P=0.000 and P=0.001,respectively).The median time to diagnosis in postnatal group was 12.5 days.Conclusions The "integrated management" mode allows early diagnosis and treatment of preterm infants with CCHD,but may not reduce the rate of in-hospital death and adverse outcomes in the short term.更多还原