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目的:了解筛查中心对先天性甲状腺功能低下症待排疑似病例未终结情况,并分析其原因,以便制定正确预防措施。方法:将2006~2011年的先天性甲状腺功能低下症待排疑似病例未终结情况进行分类统计分析,并对未能再召回的原因进行分析。结果:2006~2011年108先天性甲状腺功能低下症待排未召回疑似病例中男性60例,女性48例;福州43例,占39.8%,宁德30例,占27.8%,南平27例,占25%,莆田6例,占5.6%,其他地区2例,占1.8%;2006年10例,占9.2%,2007年11例,占10.2%,2008年13例,占12%,2009年12例,占11.1%,2010年27例,占25%,2011年35例,占32.4%。初检弱阳性51例,占47%,阳性57例,占53%。在初检弱阳性中有9例第1次召回结果上升达到阳性,然后再下降;有16例第1次召回结果上升达到阳性,未召回再召回进行确诊,9例促甲状腺素(TSH)18~30 mL/L,4例TSH 30~50mL/L,3例TSH>50 mL/L。在初检阳性中37例复检TSH<20 mU/L,9例TSH 20~30 mU/L,1例TSH>30 mU/L。75例第1次召回后未能再次召回,占69.4%,第2次召回23例,占21.2%,第3召回4例,占3.7%,第4次及以上召回4例,占3.7%。结论:通过对先天性甲状腺功能低下症待排疑似病例未终结情况分析,加强对患者宣传筛查复检的重要性,尽可能将血清复检安排在县级医院,召回工作县县级妇幼保健机构承担,健全考核机制,保证召回工作的质量;同时对困难家庭尽可能给补助,让每个疑似病例都能得到诊断和排除。
OBJECTIVES: To understand the status of unverified cases of screening for congenital hypothyroidism in screening centers and to analyze the causes for the establishment of proper preventive measures. Methods: The classification and statistical analysis of the unpredictable cases of congenital hypothyroidism from 2006 to 2011 were conducted, and the reasons for the failure to be recalled were analyzed. Results: From 2006 to 2011 108 cases of congenital hypothyroidism were not scheduled to recall suspected cases of male 60 cases, female 48 cases; Fuzhou 43 cases, accounting for 39.8%, Ningde 30 cases, accounting for 27.8%, Nanping 27 cases, accounting for 25 6 cases in Putian, accounting for 5.6%; 2 cases in other regions, accounting for 1.8%; 10 cases in 2006, accounting for 9.2%; 11 cases in 2007, accounting for 10.2%; 13 cases in 2008, accounting for 12%; 12 cases in 2009 , Accounting for 11.1% in 2010, 27 cases, accounting for 25% in 2011, 35 cases, accounting for 32.4%. The first weak positive in 51 cases, accounting for 47%, 57 were positive, accounting for 53%. In the first weakened positive, 9 cases of the first recalled results rose to positive, then decreased again; 16 cases of the first recalled results rose to positive, did not recall and then recalled to confirm, 9 cases of thyrotropin (TSH) 18 ~ 30 mL / L, 4 TSH 30 ~ 50 mL / L, 3 TSH> 50 mL / L. In the first positive examination, 37 cases had TSH <20 mU / L, 9 TSH 20-30 mU / L, and 1 case TSH> 30 mU / L. 75 cases failed to be recalled after the first recall, accounting for 69.4%, the second recalled 23 cases, accounting for 21.2%, the third recalled in 4 cases, accounting for 3.7%, the fourth and above recalled in 4 cases, accounting for 3.7%. Conclusions: Through the analysis of the unconfirmed cases of congenital hypothyroidism, we should strengthen the importance of re-screening of patients’ propaganda and screening as much as possible to arrange the re-examination of serum in the county-level hospitals and recall the county-level MCH Institutions to undertake and improve the assessment mechanism to ensure the quality of the recall; the same time as difficult as possible to help families, so that each suspected case can be diagnosed and ruled out.