地中海贫血筛查在产前检查中的临床应用

目的 探讨地中海贫血筛查在产前检查中的临床意义.方法 通过对所有孕妇实施产前地中海贫血筛查,并对筛查阳性标本进行基因诊断,对夫妻为同型地中海贫血患者进行产前诊断,杜绝重症地中海贫血患儿出生.结果 在8626例被筛查标本中,查出地中海贫血966例,占11.20%,夫妻为同型地中海贫血者26对,经产前诊断主动发现重型地中海贫血患儿7例,占26.9%.结论 在地中海贫血高发区实施产前地中海贫血筛查和产前诊断是避免重症地中海贫血患儿出生的有效措施.     

年龄和肿块大小对超声和钼靶X线在乳腺癌筛查及检查中的影响

目的 分析年龄和肿块大小对超声和钼靶X线在乳腺癌筛查及检查中的影响.方法 对受检者分别进行超声以及钼靶X线检查,对患者病变位置、声像图以及病变大小做好详细记录,诊断需要保证由超声以及放射专业的高级医师双盲状态下做出.结果 545例乳腺疾病患者中发现病灶566个,经病理诊断确诊为乳腺癌疾病的患者包括151例,包括157个病灶,良性病变394例,包括病灶409个.早期乳腺癌疾病的诊断准确率为54.14%(85/157),经超声检查发现乳腺癌灵敏度可达到95.54%(150/157),假阴性率4.46%(7/157),特异性为64.55%(264/409);经钼靶X线对乳腺癌疾病进行检查发现特异性为85.82%(351/409),灵敏度达到90.45%(142/157),假阴性率9.55%(15/157),将两种检验方法进行对比,差异有统计学意义(P<0.05).当肿块在6~10 mm左右时,钼靶X线灵敏度达到最低,相比于超声检查的灵敏度比较差异有统计学意义(P<0.05).结论 对乳腺癌疾病进行检查时发现,50岁以上(包括50岁)的女性患者经超声及钼靶X线检查,诊断结果相同,对于<50岁的患者,超声检查方式灵敏度更好,而当肿瘤直径处于6~10 mm之间时,钼靶X线检查更为适用.     

产前超声在筛查胎儿畸形中的临床价值

目的：探讨产前超声检查在筛查胎儿畸形中的临床价值。方法：回顾性分析2012年产前超声筛查的检查结果,总结胎儿畸形的检出率、系统分布以及严重程度。结果：2012年在我院接受产前超声检查的32 667例孕妇中,胎儿畸形的检出率为1.27%（414/32 667）。各系统畸形中,以心血管系统畸形最为常见（23.43％,97/414）,其次为神经系统畸形（17.15％,71/414）;严重畸形占所有检出畸形的54.59%（226/414）,其中以神经系统畸形最为常见（27.88％,63/226）。结论：产前超声检查对筛查胎儿畸形,减少出生缺陷有着重要的临床价值。     

临床乳腺检查筛查乳腺癌中降低病灶漏报率的探讨

目的 探讨临床乳腺检查筛查乳腺癌中降低病灶漏报率的方法 .方法 统计北京协和医院健康医学中心2181例女性乳腺异常病例,分析各种检查方法 的病灶漏报情况.结果 2181例中问诊及望诊降低漏报率0.5%;异常病灶2839个,多种体位联合触诊使漏报率由0.9%减至0.4%;乳腺小结节、乳腺边缘、腋窝、乳晕区病灶及腺休局限性增厚易漏报.手术组乳腺癌与良性病变比较两组之间的差别,问诊望诊异常有非常显著意义(x2=9.770,P=0.002)、触诊结节硬度差异无统计学意义(x2=1.692,P=0.193).乳腺癌病灶漏报率分别为临床检查3.7%;超声检查17.0%;钼靶检查19.4%.结论 临床乳腺检查筛查乳腺癌中降低病灶漏报率的方法 :重视问诊及望诊;依据乳腺形态灵活运用多种触诊方法 ;勿忽视乳腺边缘、腋窝及乳晕区病灶;关注触诊腺体局限性增厚;触诊结节硬度不宜作为判断乳腺癌的独立指征;避免对触诊的盲目自信或过度信赖仪器检查.     

Satisfaction with breast cancer screening and future screening participation.

BACKGROUND: To measure satisfaction with an investigational breast cancer risk screening technique [electrical impedance scanning (EIS)] and to investigate the relationship between satisfaction and willingness to return for follow-up examination one year later. MATERIAL/METHODS: 2727 women volunteers (age 18-45 years, military healthcare beneficiaries) underwent an EIS exam [reported as "negative" (average risk) or "positive" (high risk)]; then they filled out a questionnaire assessing satisfaction with the procedure. One year later, women were invited for follow-up screening. RESULTS: Satisfaction score was significantly related to EIS exam result (higher for women with negative exams), importance assigned to breast cancer screening, and family history of breast cancer. However, satisfaction was not related to scheduling a visit the following year for a follow-up examination. The only satisfaction component predicting return was satisfaction with exam reporting for participants with positive exam results. Return was related positively to age and race/ethnicity; older women and Hispanic women were more likely, while African American women were less likely, to return for follow-up. CONCLUSIONS: Factors affecting breast cancer screening participation among younger women are diverse and complex. Further study and delineation of such factors is necessary to understand how best to tailor breast cancer education programs in young women.