摘要
目的:通过实施儿童慢性肾脏病的双重筛查模式,早发现和诊断严重先天性泌尿系统畸形、儿童慢性肾脏病的患儿,建立"初级登记、二级筛查随访、三级诊治严重患儿"的三级管理模式,有效管理患儿,减少终末性肾病的发生。方法:对高危儿行泌尿系统超声检查,异常者行尿常规检查,符合转诊标准者转三级医院就诊,不符合转诊者建立档案,定期随访。在学校范围内采用尿液试纸目测法检测尿液,2次检查呈阳性者转至二级医院就诊,行尿液镜检或尿沉渣分析,阳性者为尿检异常,对其中符合转诊条件者转诊至三级医院,对不符合转诊条件者随访。结果:超声筛查高危儿479例,异常者69例,阳性率14.14%,转上级医院6例。尿液筛查总人数2926例,第1次尿筛阳性533人(18.22%),第2次尿筛阳性126人(4.31%),二级医院尿检阳性33人(1.13%),转诊至三级医院3例。结论:儿童慢性肾脏病双重筛查模式具有经济、可操作性强等优点,能有效筛查出肾脏病患儿,其三级管理模式能对筛查出的患儿进行有效的管理,适合我国国情,适合在基层推广运用。
Objective： To make the children screening effectively managed, and to reduce the incidence of terminal kidney disease ultimately, we adopt a double screening model for childhood chronic kidney disease, so we can detect and diagnose the severe congenital urinary system deformities and chronic kidney disease in children early. We establish three-grade management model of primary registration, secondary screening fol low-up, three-grade diagnosis and treatment. Methods： The high-risk children were treated with a line urinary system ultrasound examination, abnormal patients were given further routine urine examination. If the pa tients meet the referral criteria, they will transfer to tertiary hospitals with regular follow-up. Urine screening： urine testing was made in the school （primarY）. If students were positive urine screening for, they would transferred to the secondary hospital. And line urine microscopy or urine sediment analysis were made among students. Students who were positive for urine test abnormal and referral conditions were transferred to the tertiary hospital. Students who did not meet the referral conditions were followed. Results： 479 cases of high risk children were diagnosed by ultrasound. The positive rate was 14.14% and 6 cases were transferred to higher grade hospital. The total number of urine screening were 2926 cases and the positive rate of 16.16%. 6 cases were transferred to tertiary hospital. The total number of urinary screening was 2926 cases, the number of people with positive results at the first time was 533 （18.22%）, the number for the second time was 126 （4.31%）, and the number of positive urine test in the secondary hospital was 33 （1.13%）. Conclusion： The dual screening model of chronic kidney disease in children has the advantages of economy and operability, and can effectively screen out children with kidney disease. The three-level management model can effectively manage the children who are screened out, and are suitable for promotion in the gras
出处
《数理医药学杂志》
2017年第12期1822-1824,共3页
Journal of Mathematical Medicine
基金
卫生部行业科研专项基金资助(NO.201002006)
关键词
慢性肾脏病
儿童筛查
超声检查
尿检
chronic kidney disease
children screening
uitrasound screening
urine examination
