2926例学龄儿童尿液筛查分析  

Analysis of 2 926 cases of school-age children urine screening

作　　者：沈汉玲 黄高明[1] 夏玉明[1] 沈玉琳[1] 刘长华[1] 唐慧[1] 刘世芬[1] 靳军[1] 刘厚存[1] 邬随焕 别川定 

机构地区：[1]湖北省随州市妇幼保健院儿科,随州441300

出　　处：《临床肾脏病杂志》2014年第11期657-660,共4页Journal Of Clinical Nephrology

基　　金：卫生部行业科研专项基金资助（NO.201002006）

摘　　要：目的通过实施学龄儿童慢性肾脏病（chronic kidney disease,CKD）的尿液筛查模式,及早发现和诊断CKD,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,从而使筛查出的肾脏病患儿得到有效管理,最终减少终末性肾病的发生率。方法选择小学一年级和六年级的学生3015名,由学校发放《告知尿液筛查告家长书》及专用试管留取晨尿。采用尿液试纸目测法检测尿液,将2次尿液筛检查均出现潜血、蛋白质或白细胞阳性者转至随州市妇幼保健院就诊,行尿液镜检或尿沉渣分析,阳性者定为尿检异常,对其中符合转诊条件者转诊至三级医院接受治疗,对不符合转诊条件者进行治疗或建档随访。结果完成尿液筛查总人数2926例,一年级有1533例（占53.39%）,六年级有1393例（占47.61%）。第一次尿液筛阳性人数533人（占18.22%）,第二次尿液筛阳性人数126人（占4.31%）。二级医院尿检阳性人数33人（占1.13%）,其中一年级23例（占0.79%）,六年级10例（占0.34%）,男生10例（占0.34%）,女生23例（占0.79%）。有3例患儿根据病情转诊至三级医院,17例尿白细胞阳性患儿经本院治疗后复查尿检转阴,6例确诊肾积石给予排石药物治疗,剩余7例每6月复诊随访1次,并建立随访档案。结论儿童 CKD尿液筛查模式具有经济、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 Through the implementation model of chronic kidney disease of urine screening for school-age children,to early detect and diagnose chronic kidney disease （CKD）in chil-dren,establish the three-level management mode of “registration,screening and follow-up,and diag-nosis and treatment of severe CDK in the children＂,and thereby manage the children with kidney dis-ease effectively,and ultimately reduce the incidence of end-stage nephropathy.Methods 3 015 first-grade and sixth-grade students were selected,“a report letter to the parents about the urine screening”was issued by the schools,and morning urine specimens were obtained using special tubes.The urine was tested using visual method of urine test paper.The children with occult blood,protein,or white blood cells twice were sent to Suizhou Maternal and Child Health Hospital for urine microscopy or u-rine sediment analysis.Urine abnormalities were defined as the urine positive results.The children meeting the standards for transfer were transferred to a tertiary hospital for treatment,and the rest children were given treatment or follow-up.Results The total number of completing urine screening was 2 926 cases,including 1 533 cases in the first grade （accounting for 53.39%）,and 1 393 cases in the sixth grade （accounting for 47.61%）.The urine test was positive in 533 （18.22%）children in the first screening,and 126 （4.31%）in the second screening.Urine test was positive in 33 cases （1.13%）in the second-level hospitals,including 23 cases （0.79%）in the first grade,and 10 cases （0.34%）in the sixth grade [10（0.34%）boys and 23（0.79%）girls].Three children were trans-ferred to tertiary hospitals according to their ill conditions.Seventeen cases positive for urinary leuko-cytes obtained negative urine test after treatment.Six cases were diagnosed as having kidney stone and given medication.The rest 7 cases were followed up once every 6 months,and follow-up file was es-tablished.Conclusions The mode of urine screening fo

关 键 词：慢性肾脏病 儿童 筛查 

分 类 号：R714.53[医药卫生—妇产科学]