探讨在资源相对匮乏的中国西部县、乡级医院，采用新生儿脉搏血氧饱和度(SpO₂)筛查，对于早期发现新生儿感染及肺部疾病的有效性及可行性。

选择2015年9月至2017年6月，在北川羌族自治县人民医院、三台县妇幼保健院及游仙区妇幼保健院等四川省绵阳市14家县、乡级医院产科出生、无明显异常临床表现的15 720例新生儿为研究对象。于新生儿生后12 h时进行第1次SpO₂监测，若结果为正常，则在其生后48 h时，进行第2次SpO₂监测；若12 h时的SpO₂监测结果呈阳性，则不进行48 h时的第2次SpO₂筛查。将SpO₂筛查结果呈阳性者转入新生儿病房，进一步完善超声心动图检查，以明确有无危重型先天性心脏病，并对无危重型先天性心脏病的患儿，根据其随后的临床表现及实验室检查结果，进一步分析引起其发生低氧血症的原因。本研究遵循的程序符合2013年修订的《世界医学协会赫尔辛基宣言》要求，获取所有筛查对象监护人的知情同意。

①本研究15 720例新生儿中，SpO₂筛查结果呈阳性者共计34例，新生儿SpO₂筛查阳性率为0.2%。②这34例SpO₂筛查结果呈阳性的患儿中，危重型先天性心脏病患儿为6例，新生儿肺炎患儿为19例，新生儿败血症患儿为5例，新生儿气胸患儿为3例，新生儿湿肺患儿为1例。其中，28例非心脏因素所致低氧血症患儿，均在SpO₂筛查结果判断为阳性时，立即转至新生儿病房进行及时、有效治疗，均痊愈出院。

在基层医院，对产科娩出48 h内的新生儿常规进行SpO₂筛查，有利于早期发现危重型先天性心脏病及其他原因导致的低氧血症患儿，从而达到对其进行及时、有效救治的目的。新生儿SpO₂筛查操做简单、仪器成本低，值得在基层医院广泛推广。

To explore the effectiveness and feasibility of early detection of neonatal infection and pulmonary disease by pulse oxygen saturation (SpO₂) screening at county, township and village level hospitals in western area of China with relatively short of resources.

A total of 15 720 newborns without obvious abnormal clinical manifestations from September 2015 to June 2017 who were born at 14 county and village level hospitals in Mianyang City, Sichuan Province such as People′s Hospital of Beichuan Qiang Autonomous County, Maternal and Child Health Hospital of Santai County, Maternal and Child Health Hospital of Youxian District, etc., were chosen as research subjects. At 12 h after birth, SpO₂ screening was implemented. The first screening result was negative, then the second screening would be done at 48 h after birth, on the contrary, then that second screening was not done. Newborns those who had positive screening results were transfered to Department of Neonatology, in order to clarify the presence of critical congenital heart disease by echocardiography. The causes of hypoxemia in neonates without critical congenital heart disease were further analyzed by clinical manifestations and laboratory examination results. This study was in line with World Medical Association Declaration of Helsinki revised in 2013, and informed contents were obtained from guardians of all participates.

① Among 15 720 neonates of this study, a total of 34 cases had a positive screening results of SpO₂, positive rate of screening test of SpO₂ was 0.2%. ②Among 34 cases with screening positive results of SpO₂, there were critical congenital heart disease, neonatal pneumonia, neonatal sepsis, pneumothorax and wet lung of newborns of 6, 19, 5, 3 cases and 1 case, respectively. All 28 neonates with hypoxemia who were not caused by heart disease were immediately transferred to Department of Neonatology for timely and effective treatment, and all discharged from hospital after recovery.

In primary level hospitals, routine screening test of SpO₂ to newborns within 48 h after birth, may helpful for eraly find neonate with critical congenital heart disease and other causes of hypoxemia to take timely and effective treatment measures. Operation of neonatal screening test of SpO₂ is simple and its equipment cost is low. Clinical application of neonatal screening test of SpO₂ shows an advantage in primary level hospitals widely.