儿童慢性肾脏病双重筛查模式及随访管理

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1、儿童慢性肾脏病双重筛查模式及随访管黄高明沈汉玲随州市妇幼保健院摘要：R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

2、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，界常者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人仃8.22%）,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。关键词：慢性肾脏病;儿童筛查;超声检查;尿检;收稿

3、日期：2017-06-20基金：卫生部行业科研专项基金资助（NO.201002006）DoubleScreeningModelandFollow-upManagementforChronicRenalDiseaseChildrenHuangGaomingSuizhouMaternalandChildHea1thHospital;Abstract：Objective:TomakethechiIdrenscreeningeffectivelymanaged,andtoreducetheincidcnccof

4、tcrminalkidneydiseaseultimately，weadoptadoublescreeningmodelforchildhoodchronickidneydisease,sowecandetectanddiagnosetheseverecongenitalurinarysystemdeformitiesandchronickidneydiseaseinchildrenearly.Weestablishthree-grademanagementmodelofprimaryregistrat

5、ion,seconda/ryscreeningfollow-up,three-gradediagnosisandtrcatment.Methods:Thehigh-riskchildrenweretreatedwithalineurinarysystemultrasoundexamination,abnormalpatientsweregivenfurtherroutineurineexamination.Ifthepatientsmeetthereferralcriteria,theywilltran

6、sfertotertiaryhospitalswithregularfollow~up.Urinescreening:urinetestingwasmadeintheschool(primary)•Ifstudcntswerepositiveurineserecningfor,theywouldtransferredtothesecondaryhospital.Andlineurinemicroscopyorurinesedimentanalysisweremadeamongstudents.Stude

7、ntswhowerepositiveforurinetestabnormalandreferralconditionsweretransferredtothetertiaryhospitai.Studentswhodidnotmeetthereferralconditionswerefollowed.Rcsults:479casesofhighriskchildrcnwerediagnosedbyultrasound.Thepositiveratewas14.14%and6casesweretransf

8、erredtohighergradehospital.Thetotalnumberofurinescreeningwere2926casesandthepositiverateof16・16%.6casesweretransferredtotertiaryhospitai.Thetotalnumberofurinaryscreeningwas2926cases,thenumberofpeoplewithpositivcresuItsatth