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目的通过对可疑甲状腺功能减低症患儿召回确诊情况进行回顾性分析,探讨可疑甲状腺功能减低症患儿未能召回确诊的原因及如何进一步优化筛查流程,提高筛查效率。方法选取2014年6月-2015年6月株洲市妇幼保健院筛查出的可疑甲状腺功能减低症患儿377例,依据召回确诊情况分为召回组(343例)和未召回组(43例),分别对召回组在不同切值时召回确诊情况及阳性预测值和未召回组的未召回原因进行分析。结果 1、筛查值TSH≥20μU/ml时,确诊为甲状腺功能减低症(CH)和高TSH血症的阳性预测值为85.19%;筛查值TSH≥30μU/ml时,二者阳性预测值为100%;筛查值TSH≥60μU/ml时,阳性预测值为100%,且全为CH病例。2、未召回可疑患儿主要以低文化程度和低收入家庭为主,与召回组比较差异有统计学意义(P<0.05)。结论加强对低文化程度和低收入家庭的宣教和帮扶工作是提高召回率的有效方法,确保可疑患儿进一步明确诊断和得以及时治疗的重要途径;同时优化筛查流程更有利于患儿的早诊断、早治疗。
Objective To retrospectively analyze the diagnosis of recall in children with suspected hypothyroidism (Hypothyroidism). To investigate the causes of recall failure in children with suspected hypothyroidism (Hypothyroidism) and how to further optimize the screening procedure and improve the screening efficiency. Methods 377 cases of suspected hypothyroidism were screened in Zhuzhou MCH from June 2014 to June 2015. According to the diagnosis of recall, there were 343 recalled cases and 43 recalled cases without recall. , Respectively, the recall group at different cut-off value of the recall and positive predictive value of the recall group did not recall the reasons for the analysis. Results 1. The positive predictive value of TSH≥20μU / ml was 85.19% when diagnosed as hypothyroidism (CH) and hyper-TSH. When TSH≥30μU / ml, the positive predictive value 100%; screening value TSH ≥ 60μU / ml, the positive predictive value was 100%, and all CH cases. (2) Suspected children who were not recalled were mainly low-educated and low-income families, and there was significant difference compared with the recalled group (P <0.05). Conclusion Strengthening the education and helping to low-income families and low-income families is an effective way to improve the recall rate, to ensure that suspicious children further diagnosis and timely treatment of important ways; while optimizing the screening process is more conducive to children’s Early diagnosis, early treatment.