目的 探讨Graf法超声在6个月以内婴儿发育性髋关节异常筛查及随访中的应用价值。方法 选取我院2014年1月—2017年6月2 000例0～6个月婴儿(4 000个髋关节)为标本,采用Graf法超声检查进行筛查,检测发病率,并对部分髋关节异常的婴儿进行随访。结果 Ⅰ型髋关节3 572例(89.3%),Ⅱ型336例(8.4%),Ⅲ型92例(2.3%)。随访的272例发育性髋关节异常婴儿中,86例Ⅱ型转化为Ⅰ型,42例Ⅲ型转化为Ⅰ型,46例Ⅱa型转化为Ⅱb型,98例Ⅱ型无转化。结论 Graf法超声检查在婴儿髋关节异常筛查以及随访中有较高的使用价值。Graf法超声检查安全性好、有效率高,有助于发育性髋关节异常疾病的早期诊断及早期治疗。

目的 探究聚乙二醇筛查法在高泌乳血症诊断中的临床意义。方法 选取260例HP患者作为观察组以及80例健康体检者作为对照组。应用雅培I2000全自动化学发光检测仪对两组标本进行PRL浓度测定,并将标本进行PEG筛查法沉淀后再次进行PRL浓度测定,将所得数据进行对比。结果 观察组检出MP67例,检出率25.77%,对照组检出MP3例,检出率3.75%,二者差异有统计学意义(P＜0.05);HP组、MP组和对照组之间PEG沉淀前PRL浓度差异有统计学意义(P＜0.05),沉淀后HP组和MP组以及对照组差异有统计学意义(P＜0.05),MP组和对照组差异无统计学意义(P＞0.05);MP在HP引起的各种临床疾病中检出情况差异无统计学意义(P＞0.05)。结论 应用聚乙二醇筛查法对于排除MPRL对HP诊断的干扰具有可行性,对降低HP的误诊率有着重要的意义。

Objective To explore the clinical signification of polyethylene glycol screening method on the diagnosis of hyperprolactinemiat.Methods We selected 260 patients with hyperprolactinemia as observation group and 80 healthy individuals as control group. The two groups were measured with Abbott laboratories I2000 automatic chemiluminescence detector about the concentration of PRL. Then the groups were measured again after they were precipitated by the polyethylene glycol and the result data were analyzed.Results 78 cases of MP were checked out from the observation group and 3 cases were checked out from the control group. The proportion was 25.77% and 3.75% respectively, and the differences were statistically significant (P＜0.05). The difference of the concentration of PRL before precipitated by PEG among the HP group, the MP group and the control group were statistically significant (P＜0.05). After precipitating, the difference of the concentration of PRL between the HP group and the MP group were statistically significant (P＜0.05), as well as the HP group and the control group. However, there was no difference between the MP group and the control group (P＞0.05). The checking conditions of MP in some diseases caused by HP had no difference(P＞0.05).Conclusion The use of polyethylene glycol screening method is a practicable method to eliminate the interference of MPRL on the diagnosis in HP. It has significance reducing misdiagnosis rate of HP.

目的 了解新生儿先天性心脏病的患病情况,为制定和采取干预措施提供依据。方法 对2015年10月—2016年9月分娩的5 769名新生儿进行心脏彩超检查,根据筛查结果进行统计分析。结果 共筛查出182例新生儿先天性心脏病,患病率3.15%,先天性心脏病新生儿中女婴比例较高,差异边缘显著,早产儿比例较高,差异有统计学意义,产母年龄和正常组分布相近。先天性心脏病类型中室间隔缺损和房间隔缺损的构成比分别排第一位(48.90%)和第二位(38.46%),严重先天性心脏病仅占5.43%。结论 新生儿先心病的发病率较高,采用心脏彩超筛查可尽早发现先心病患儿,同时需做好先心病患儿的随访工作,及时进行干预。

Objective To investigate the prevalence of neonatal congenital heart diseases (CHD) and providing basis for integrating efficient interventions. Methods The color Doppler echocardiography screening were applied to 5 769 newborns from Oct 2015 to Sep 2016, and the data was collected and analyzed. Results 182 cases of neonatal CHD were detected, and the prevalence rate of neonatal CHD was 3.15%. The proportion of girls and premature infants in the newborns with CHD was significantly higher than normal newborns, but the age distribution of their mothers was similar. In the 182 CHD cases, ventricular septal defect(48.90%) and atrial septal defect(38.46%) accounted for the most, while the constituent ratio of severe CHD was only 5.43%. Conclusion The prevalence of neonatal CHD was relatively high, and the color Doppler echocardiography screening could find out neonatal CHD earlier. The follow-up examinations and interventions should be conducted in time.

目的 探讨妇科门诊宫颈癌高危人群采取阴道镜检查后配合宫颈细胞学检查对宫颈癌筛查价值。方法 选取2016年2月—2017年4月我院妇科门诊就诊合并宫颈癌高危患者387例为研究对象,所有患者均行阴道镜检查和宫颈细胞学检查,以最终病理检查为诊断“金标准”,探究阴道镜、宫颈细胞学检查在宫颈癌中筛查灵敏度、特异度及阳性符合率。结果 387例纳入研究宫颈癌高危患者,经病理诊断后明确诊断为宫颈癌51例,占13.18%。细胞学检查在宫颈癌中筛查灵敏度为72.55%,特异度为90.48%,阳性符合率为88.11%。阴道镜检查在宫颈癌中筛查灵敏度为50.98%,特异度为94.64%,阳性符合率为88.89%。宫颈癌筛查中,细胞学检查灵敏度高于阴道镜检查,特异度低于阴道镜检查(P＜0.05),两者检查阳性符合率比较差异无统计学意义(P＞0.05)。结论 妇科门诊宫颈癌高危患者宫颈筛查中,阴道镜筛查具有较高特异度,细胞学检查具有较高灵敏度,联合检查能提高筛查价值。

目的 探讨血清胃蛋白酶原在胃癌筛查中的价值。方法 用ELISA方法对1102名患者血清PG水平进行检测,并行内镜病理组织学检查,采用ROC曲线确定PG筛查胃癌的最佳界定值。结果 与对照组、萎缩性胃炎组、胃良性溃疡组相比,早期胃癌组、进展期胃癌组PGI、PGR下降(P＜0.05),进展期胃癌组PGI、PGR较早期胃癌组下降(P＜0.05)。与对照组相比,早期胃癌组、进展期胃癌组、胃良性溃疡组PGII升高(P＜0.05)。PGI及PGR在ROC曲线下面积为0.920和0.831,对胃癌的诊断价值较高。PGI≤71.50 μg/L或PGR≤4.50作为筛查标准时,对胃癌高危人群筛查的灵敏度为83.33%,特异度为82.25%。结论 血清PGI、PGR在不同胃部病变中的表达水平不一致,对胃癌的早期筛查和早期诊断具有重要价值。PGI≤71.50 μg/L或PGR≤4.50是东莞地区筛查胃癌较合适的界定值。

Objective To investigate the value of serum pepsinogen PG detection for screening of gastric cancer. Methods PG was detected by ELISA of 1102 people, gastrointestinal endoscopy and biopsy pathology were also carried on. Using ROC curve to establish the PG screening standard, and verified its' value at high risk population of gastric cancer. Results Compared with control group, atrophic gastritis group and benign gastric ulcer group, serum PGI and PGR in early gastric cancer group and advanced gastric cancer group decreased significantly(P＜0.05). Serum PGI and PGR in advanced gastric cancer group were lower than early gastric cancer group(P＜0.05). Serum PGII in early gastric cancer group, advanced gastric cancer group and benign gastric ulcer group were higher than control group(P＜0.05). The area under ROC curve of PGI and PGII was 0.920 and 0.831 respectively, both of them showed high value for the diagnosis of gastric cancer. Took PGI≤71.50μg/L or PGR≤4.50 as the diagnosis criteria, the sensitivity was 83.33% and specificity was 82.25% at high risk population of gastric cancer. Conclusion Serum PGI and PGR were inconsistent in different gastric disease, which showed high sensitivity and specificity in the screening of gastric cancer,and have important value in early screening and early diagnosis of gastric cancer. PGI≤71.50μg/L or PGR≤4.50 were established as the appropriate standard for PG screening.

目的 研究探讨南沙区宫颈癌HPV筛查的认知程度及干预工程的效果。方法 选取2014年7月—2015年6月通过随机抽样抽取的南沙区21～60岁的妇女1000例为研究对象,通过问卷对其宫颈癌认知情况进行调查,并且根据筛查结果进行有针对性的干预措施。结果 南沙区的妇女只有35%既往有按时定期进行宫颈癌的筛查,只有13%做过HPV的筛查。筛查的900例中,HPV感染率6.78%,其中CIN1级为0.78%,CIN2级为0.44%,CIN3级为0.33%,疑浸润癌为0.11%。结论 南沙区妇女对宫颈癌HPV筛查的认知程度较低,通过对育龄妇女实施HPV筛查及干预工程,能够针对不同人群给予有针对性的干预措施,对农村育龄妇女的宫颈癌早期诊断及预防具有积极的意义。

目的 了解惠州市早产儿视网膜病变的发病状况,并探讨相关危险因素。方法 回顾分析我院在2015年1月—2015年9月776例(1552只眼)早产儿和低体重儿的眼病筛查资料。结果 776例早产儿中,发现各期ROP共27例,检出率3.479%,其中包括1期11例(18只眼),2期11例(22只眼),3期2例(4只眼),AP-ROP3例(6只眼)。统计学分析显示,ROP组和无ROP组在出生胎龄、出生体重、吸氧史间比较,差异有统计学意义,提示早产、低出生体重与ROP的发生密切相关。结论 惠州地区ROP发病率3.479%,出生体重、出生胎龄、吸氧史及宫内缺氧、母体慢性高血压合并妊娠等孕期母体因素都是影响其发生的高危因素。

Objective To study the incidence of retinopathy of prematurity and to analyse the risk factors for ROP. Methods A retrospective analysis was conducted on 776 premature children from January 2015 to September 2015. Results In the 776 premature babies examinaion, 26 cases(54 eyes, 3.479%)developed ROP, including 11 cases (18 eyes) suffering from stage 1,11 cases (22 eyes) from stage 2,2 cases (4 eyes) from stage 3,3cases (6 eyes) from AP-ROP. The results of statistical analysis showed that gestational age, birth weight and oxygen therapy were significantly to ROP. Clinical analysis indicated that prematurity, low birth weight and oxygen therapy were closely related to the occurrence of ROP. Conclusion The incidence of ROP in Huizhou city is 3.479%. The gestational age, birth weight ,intrauterine hypoxia, and maternal prenatal factors such as chronic hypertension with pregnancy are the high risk factors of ROP.

目的 了解非结核分枝杆菌肺病患者营养风险、营养不足发生率,以及营养支持的应用状况,为临床实施营养干预提供参考依据。方法 对2012年10月—2014年10月在广州市胸科医院就诊的非结核分枝杆菌肺病患者(符合NRS2002评定标准)的营养风险筛查与营养支持状况进行回顾性分析。结果 402例患者中,营养不足和营养风险的发生率分别为35.8％(144/402)和66.7％(268/402);所有患者中,总体营养支持率为60.0%(241/402), 使用肠外营养与肠内营养的比例为3.2∶1;老年患者,女性患者,复治患者更是发生营养风险和营养不足的高危人群;存在营养风险患者的营养支持率为82.1%(220/268),不存在营养风险患者营养支持率为15.7%(21/134)。结论 非结核分枝杆菌肺病患者存在较高比例的营养不足和营养风险,肠外肠内营养临床应用存在不合理性;应推广和使用NRS2002营养评定方法和肠内肠外营养指南,作为实施营养支持的依据。

Objective To investigate prevalence of nutritional risk, undernutrition, and nutritional support of hospitalized patients with non-tuberculosis mycobacteria. Methods Adult patients in Guangzhou Chest Hospital from October 2012 to October 2014 were enrolled by fix-point consecutive sampling. Nutritional Risk Screening 2002 (NRS2002) was performed and nutritional support was evaluated in all patients. Results A total of 402 patients were enrolled.Overall prevalence of undernutrition was 35.8%, and nutritional risk was 66.7%. Among all the patients, the rate of nutritional support was 60.0%, including 82.1%of patients with nutritional risk and 15.7% of non-risk patients. Gerontal patients, retreatment patients and female patients are in the greater possibility of being expose to nutritional risk or undernutrition. Conclusion A large proportion of inpatients with non-tuberculosis mycobacteria were at nutritional risk or undernutrition.The application of parenteral or enteral nutritional support currently maybe inappropriate. NRS2002 and parenteral or enteral nutrition guideline are required to affording nutritional support.

目的 研究并探讨产前优生筛查对出生缺陷的干预作用。方法 于2013年1月—2015年12月,选取69 183例孕产妇的临床资料进行回顾性研究,胎儿总数为69 262例,所有孕产妇在妊娠期均进行产前优生筛查,对产前筛查结果进行分析,统计胎儿异常例数,采取相应的产前干预措施,并对未检出胎儿异常的孕产妇进行跟踪随访,观察其妊娠结局,统计出生缺陷儿娩出例数及产前筛查漏检率。结果 69 262例胎儿中,共有7 470例胎儿检出异常,其胎儿异常率为10.79%,其中2013年检出1 910例,2014年检出2 569例,2015年检出2 991例,其检出率分别为9.15%、10.70%、12.17%,最终经产前诊断检查确定为出生缺陷的胎儿共98例,均采用引产术以终止妊娠。对未检出异常的61 792例胎儿进行跟踪随访后发现,其中17例胎儿在孕期流产,有9例出生缺陷儿娩出,其出生缺陷发生率为0.1 457‰,其产前筛查漏检率为0.1 456‰。结论 在产前对孕产妇进行产前优生筛查,并根据产前筛查结果进行相应的干预,可有效检出异常胎儿,及时终止异常妊娠,有利于减少缺陷儿的出生,促进优生优育。

Objective To study and discuss intervention effects of prenatal eugenic screening in birth defects. Methods From January 2013 to December 2015, we did retrospective study on the clinical data of 69 183 cases of pregnant in which there were 69 262 fetal cases, made prenatal eugenic screening for all pregnant women. Prenatal screening results were analyzed, fetal abnormal cases were calculated. We took appropriate prenatal intervention measures, and followed up pregnant women who had no detection of fetal abnormal. We observed the pregnancy outcome, and calculated the defected childbirth cases and prenatal screening miss rates. Results 69 262 cases of fetus, a total of 7 470 cases of fetal abnormalities were detected. The fetal abnormality rate was 10.79%, of which 1 910 cases were in 2013, 2 569 cases in 2014, 2 991 cases in 2015. The detection rates respectively were 9.15%, 10.70%, 12.17%. 98 cases were determined as fetal birth defects by the final prenatal diagnosis examination, in which all adopted induction of labor to terminate pregnancy. 61 792 cases who were not detected anomalies were followed up in which 17 cases of fetus were found and had abortion during pregnancy, and 9 cases of fetal birth defects were delivered . The incidence of birth defects was 0.1 457 ‰, the prenatal screening miss rate was 0.1 456 ‰. Conclusion Pregnant women were made prenatal eugenic screening and according to the result of prenatal screening we took corresponding intervention, which is effective detect abnormal fetus. We may have timely termination of abnormal pregnancy,and reduce birth defects. It may promote human eugenics.

目的 调查住院患儿的营养风险及营养状况,探讨儿科营养风险筛查新方法的应用。方法 使用新的儿科营养风险筛查工具,对住院患儿进行营养风险筛查,根据体格测量评价儿童营养状况;与国外三种儿科营养风险筛查工具比较一致性。结果 402例住院患儿中高营养风险患儿占24.1%,营养不良的检出率为18.4%。有36.8%的患者接受营养支持,其中肠外营养支持率为23.1%,肠内营养支持率为16.7%,PN:EN为1.39:1。结论 对住院患儿采用新方法做营养风险筛查,能客观地反映住院患儿的营养风险,为临床营养支持提供依据。

Objective To investigate nutritional risk and the nutritional status in hospitalized children,and to validate the new screening tool of nutritional risk in hospitalized pediatric patients. Methods The nutritional risk of hospitalized pediatric patients was investigated using the new screening tool,and compared with other three pediatric nutritional risk screening tools;the nutritional status was assessed according to children physical measurement. Results Among 402 hospitalized children,children with high nutritional risk accounted for 24.1%.The overall prevalence of malnutrition was 18.4%.The proportion of patients receiving nutritional support was 36.8%.The rate of parenteral and enteral nutrition support was 23.1% and 16.7%,respectively.The ratio of parenteral nutrition to enteral nutrition was 1.39:1. Conclusion The new screening tool can reflect the possible nutritional risk in hospitalized pediatric patients objectively and provide the basis for clinical nutritional support.