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目的探索建立胆道闭锁症的筛查流程及大便比色卡用于胆道闭锁症筛查的方法学评价。方法对2013年12月4日至2014年4月30日在北京市朝阳区所属的25家助产机构分娩的新生儿发放大便比色卡,家长根据该卡片比对婴儿大便颜色至生后4个月,通过短信、电话和42天门诊进行结果追访,总结大便比色卡筛查胆道闭锁症的结果。结果共有19 252名新生儿参加了大便比色卡筛查胆道闭锁症,根据2014年1~3月的筛查数与活产数,应用大便比色卡筛查胆道闭锁症的筛查率91.3%;增加短信提醒追访方式后,门诊可疑患儿就诊率由0.65‰增加到1.89‰。大便比色卡阳性结果 12例,1例在生后55天确诊胆道闭锁症(Ⅲ型),3例分别于生后75天、47天、55天诊断为巨细胞病毒感染性肝炎、乳儿肝炎、肠道外营养相关性胆汁淤积症。其他8例为一过性大便比色卡阳性便。1例于生后24 h因黄疸住院,7天诊断为胆道闭锁症(Ⅲ型),未发现大便比色卡阳性便。胆道闭锁症的发病率为1∶9626。结论大便比色卡是简便有效的筛查胆道闭锁症的方法,可早期发现黄疸不明显的患儿,同时还可筛查出其他引起胆汁淤积症的疾病。
Objective To explore a screening procedure for the establishment of biliary atresia and a methodological evaluation of screening for biliary atresia with the stool colorimetric card. Methods A colorimetric card was issued to the newborn infants born in 25 midwifery institutions in Chaoyang District, Beijing from December 4, 2013 to April 30, 2014. According to the card, parents compared the color of their stools to 4 Month, by SMS, telephone and 42 days outpatient results of the follow-up, summarizes the results of colorimetric screening for biliary atresia. Results A total of 19,225 newborns participated in the screening of biliary atresia by colorimetric cardiometry. According to the number of screening and live births from January to March in 2014, the screening rate of biliary atresia screening by stool colorimetric card was 91.3 %; Increase SMS reminder follow-up visits, outpatient suspicious children visiting rate increased from 0.65 ‰ to 1.89 ‰. Stool colorimetric card positive results in 12 cases, 1 case 55 days after birth confirmed biliary atresia (Ⅲ type), 3 cases were diagnosed after the first 75 days, 47 days, 55 days as cytomegalovirus infectious hepatitis, infant hepatitis , Parenteral nutrition-related cholestasis. The other 8 cases were transient stool color-coded positive. One patient was hospitalized with jaundice 24 h after birth and was diagnosed as biliary atresia for 7 days (type Ⅲ). No positive stool colorimetric card was found. The incidence of biliary atresia was 1:9626. Conclusion Stool colorimetric card is a simple and effective method for screening biliary atresia. Early detection of children with jaundice is not obvious, and other diseases that cause cholestasis can be screened out.