系统超声检查在中孕期双胎畸形筛查中的应用价值

目的:探讨产前系统超声检查在双胎畸形筛查中的的临床应用价值。方法:选取2017年1月-2019年8月在我院产检的211例中孕期双胎妊娠孕妇,均进行规范化产前系统超声检查,并在产后对其胎儿进行随访观察,对比系统超声在双胎畸形筛查的准确率。结果:在211例双胎妊娠孕妇产后随访结果中,共检11例孕妇11个胎儿13处结构畸形,漏诊1例畸形胎儿,双胎妊娠畸形的发生率为5.21%(11/211),在双胎产前系统超声检查中,胎儿畸形筛查的准确率92.86 %(13/14),漏诊率为0.47%(1/211)。结论:规范化产前系统超声检查在中孕期双胎筛查中能够有效检查出胎儿畸形情况,具有较高的诊断准确率,可为双胎畸形筛查提供良好依据,效果显著,值得推广。     

产前胎儿行胎儿系统超声畸形筛查的效果及临床意义分析

目的:分析产前胎儿行胎儿系统超时畸形筛查的效果及临床意义。方法:选取2017年6月-2019年6月我院妇产科接受产前胎儿畸形筛查的300例孕妇作为研究对象,所有孕妇均进行胎儿系统超声检测,结合临床资料分析超声检测的临床价值。结果:300例孕妇中,共11例经分娩或引产证实存在胎儿畸形,占总例数的3.67%%(11/300),超声检测出9例,检出率为81.82%;漏诊2例,漏诊率为18.18%。结论:胎儿系统超声畸形筛查应用于产前胎儿畸形检测中,检出率较高,能够预防或降低胎儿出生后身体缺陷的发生,值得临床推广。     

产前筛查在胎儿先天性心脏病中的诊断价值

目的：探讨产前筛查在胎儿先天性心脏病中的诊断价值.材料与方法：分析2700例自2011年1月——2012年12月期间到我院行产前超声系统筛查的中晚期孕妇,入选孕周18-42周.结果：受检者中,胎儿先天性心脏病共27例,其中：室间隔缺损5例;法洛氏四联症4例;三尖瓣闭锁3例（2例合并房间隔缺损及单脐动脉,1例合并肺动脉狭窄）;三尖瓣下移畸形、单房单室、完全型大动脉转位各2例;矫正型大动脉转位1例;完全型心内膜垫缺损、部分型心内膜垫缺损、肺静脉导位引流、永存动脉干、左室发育不全各1例;漏诊3例.结论：产前筛查在胎儿先天性心脏畸形中具有较高的临床价值.     

二维、四维超声联合检查在产前胎儿畸形筛查中的应用

目的:探析二维、四维超声联合检查在产前胎儿畸形筛查中的应用效果。方法:在我院进行产前筛查的孕妇中选取900例,对于胎儿可能存在畸形的产妇分别给予二维超声诊断设为对照组,二维和四维联合诊断为观察组,对比产后胎儿出生后的结果。结果:900例孕妇娩出胎儿共计902个,经查证显示存在畸形15处,其中体表畸形9处,两组诊断胎儿畸形的符合率、诊断体表畸形的诊断符合率对比,观察组较对照组高,(P<0.05)统计学有意义。结论:联合二维和四维用于产前筛查胎儿畸形,获得的数据较为准确,值得推广及应用。     

孕11～13周~(+6)产前超声筛查胎儿肢体畸形的价值分析

目的:探讨孕11~13周~(+6)产前超声在胎儿肢体畸形筛查中的应用价值。方法:研究时间为2015年3月~2018年1月,研究对象为2994例在我院进行产前检查的孕11~13周~(+6)孕妇,所有孕妇均接受产前超声筛查,以引产后或出生后胎儿结果为参照,计算产前超声对胎儿肢体畸形的筛查灵敏度、特异度以及准确率,并采用一致性检验,分析产前超声筛查结果与引产后或出生后胎儿结果之间的一致性。结果:2994例孕妇中,共有40例产前超声检出胎儿肢体畸形,2954例产前超声未检出胎儿肢体畸形,引产后或出生后结果证实有37例胎儿肢体畸形。经计算,产前超声对胎儿肢体畸形的筛查灵敏度、特异度以及准确率分别为91.9%、99.8%、99.7%,与引产后或出生后胎儿结果之间的一致性良好。结论:孕11~13周~(+6)行产前超声可对胎儿肢体畸形予以灵敏检出,可作为胎儿肢体畸形产前筛查的主要手段。     

超声筛查在基层医院产前诊断胎儿畸形的临床应用

目的:分析基层医院中开展超声筛查对于产前诊断胎儿畸形的应用效果。方法:抽取2017年1月—2019年12月本院接受产前筛查的1000名孕产妇,均接受产前二维、四维超声筛查,与临床诊断结果进行对比并分析超声诊断效能。结果:与金标准结果对比二维超声在胎儿畸形中的产前诊断中确诊8例、漏诊6例以及疑诊4例,四维超声中确诊11例、漏诊3例以及疑诊1例;二维超声诊断中灵敏度57.14%、特异度99.59%、阳性预测值66.67%,四维超声灵敏度78.57%、特异度99.90%、阳性预测值91.67%。四维超声的诊断灵敏度、阳性预测值高于二维超声,且比较中P<0.05。结论:基层医院中进行超声筛查能够提高胎儿畸形的产前诊断价值,特别是应用四维超声检查有利于提高胎儿畸形的产前筛查效果。     

产前超声筛查五步检查法在胎儿心脏畸形诊断中的应用价值

目的 分析产前超声筛查五步检查法在胎儿心脏畸形诊断中的应用价值。方法 选取2020年1月至2021年12月我院收治的88例疑似怀有心脏畸形胎儿孕产妇为研究对象。所有研究对象均先接受常规产前超声筛查三步检查法检查,再接受产前超声筛查五步检查法检查。以分娩后新生儿心脏彩超或引产后胎儿尸检结果为金标准,比较两种检查方法的诊断效能及对不同类型胎儿心脏畸形的检出情况。结果 金标准检查结果显示,88例疑似心脏畸形胎儿中,71例确诊为胎儿心脏畸形。产前超声筛查五步检查法在胎儿心脏畸形中的诊断准确度、灵敏度均高于常规产前超声筛查三步检查法（P<0.05）;产前超声筛查五步检查法与常规产前超声筛查三步检查法在胎儿心脏畸形中的诊断特异度、阳性预测值、阴性预测值比较,差异无统计学意义（P>0.05）。产前超声筛查五步检查法对室间隔缺损、右心室肥大、心内膜垫缺损及心室发育不良综合征的鉴别准确率高于常规产前超声筛查三步检查法（P<0.05）。结论 产前超声筛查五步检查法对胎儿心脏畸形的诊断效能较优,且能有效鉴别不同类型的胎儿心脏畸形,可作为胎儿心脏畸形的产前超声筛查手段,降低心脏畸形新生儿出生...     

三级超声检查应用于胎儿先天性心脏病产前筛查中的价值研究

目的研究产前三级超声检查在先天性心脏病产前筛查中的应用价值。方法回顾性分析2014年1月-2016年1月间在本院接受常规孕检的5013例孕妇的产前三级超声检查资料,将三级超声检查结果分别与产前胎儿心脏超声诊断结果及金标准:分娩后新生儿心脏超声及终止妊娠胎儿尸检结果进行对比,分析三级超声检查与两者的一致性,以金标准为参照采取ROC曲线分析三级超声的诊断价值并计算各项诊断效能指标。结果本组资料中5013例孕妇,胎儿共计5016例,先心病检出率为:三级超声1.97%、产前胎儿心脏超声1.73%,金标准确诊结果为先心病胎儿/新生儿1.81%;三级超声与产前胎儿心脏超声结果及金标准间均具有较高一致性,产前胎儿心脏超声与金标准间具有极高一致性,P0.05。与金标准对比,产前心脏超声诊断符合率为99.90%,产前三级超声诊断符合率为99.04%。以金标准为参考值,三级超声对于先心病胎儿筛查具有中等诊断价值,AUC=0.887,P0.05。结论三级超声检查于先天性心脏病产前筛查中具有较高的诊断价值,以三级超声诊断结果为基础行进一步相关检查能够基本准确的判断出胎儿先天性心脏病情况,可为提高新生儿质量提供较为精准的依据。     

超声筛查胎儿先天性结构畸形的临床价值

目的探讨超声筛查胎儿先天性结构畸形的临床价值。方法回顾分析我院和北京市各区县妇幼保健院10 133例均有出生结局的病例资料,分析超声筛查不同结构畸形阳性率情况,以及不同时期超声筛查阳性率。结果 10 133例病例中,共发现先天性出生缺陷214例(复合畸形16例),共230项畸形,其中产前超声检出胎儿结构性畸形92例(95项),检出率0.91%,产后超声诊断31例(50项),超声共诊断畸形123例,检出率1.21%,超声误诊13例,误诊率0.13%;超声漏诊结构畸形120例,漏诊率1.18%;对致命性结构畸形诊断准确率100%。超声筛查先天性结构畸形的准确率、敏感性、特异性分别为90.44%、61.19%、99.87%。早孕、中孕和晚孕期产前超声对胎儿畸形的检出率分别为2.17%、69.57%、28.26%,以孕中期胎儿畸形检出率最高(P0.05)。结论超声是筛查先天性结构畸形直接而有效的方法,尤其在中孕期检出率最高,但存在漏诊非致命的结构异常。     

产前超声对胎儿心血管畸形的诊断及应用价值

目的：分析产前超声对胎儿心血管畸形的诊断意义，为妊娠结局的合理选择提供有价值的参考。方法：选取2018年6月~2020年12月于蚌埠医学院第二附属医院行产前超声筛查的1 200例孕妇，将筛查出的胎儿心血管畸形的超声表现与产后随访结果或引产结果对照，分析产前超声的诊断准确性及胎儿心血管畸形的致畸因素。结果：1 200例孕妇，产前超声诊断心血管畸形胎儿82例，阳性率为6.8%（82/1 200），经产后超声复查或引产后证实67例，产前超声诊断胎儿心血管畸形的准确率为81.7%（67/82）。室间隔缺损为胎儿心血管畸形的最常见类型。结论：产前超声诊断胎儿心血管畸形的准确性较高，对具有高危致畸因素的胎儿进行针对性筛查，可为胎儿预后转归提供可靠的判断依据。     

An evaluation of the accuracy and efficiency of a school screening model that uses a questionnaire

Scherrer S, Stevens JA. International Journal of Nursing Practice 1997; 3 : 89–96
An evaluation of the accuracy and efficiency of a school screening model that uses a questionnaire
The role of the school nurse is changing to meet the increasing needs for health promotion and health education. However, the evolution is being hampered by the inefficient work practices involved in undertaking some of the more traditional tasks such as school screening. A survey questionnaire model of screening was developed and trialed with a sample of students and parents and then compared with the results of the more traditional one to one screening programme. The questionnaire survey model was evaluated for accuracy and efficiency against the traditional screening model. The questionnaire method exhibited a relatively low error rate and required one third of the time to complete when compared with the traditional screening programme. The implications of these findings as well as the advantages and limitations of each model are examined in the discussion .     

不同方法在唐氏综合征产前筛查中的比较研究

目的：比较不同时期二联筛查与传统孕中期二联筛查在唐氏综合征产前筛查中的效果。方法：采用罗氏电化学检测技术,对1289例同意接受产前筛查的孕妇及5例已确诊的唐氏综合征妊娠孕妇的冻存血清标本在孕周11-14周的孕妇测定PAPP—A、Free8-HCG,再于孕16-20周检测AFP、B—HcG浓度,分别计算不同时期二联筛查和传统孕中期二联筛查的风险值、检出率和假阳性率。结果：本研究中孕早期栓出唐氏综合征高风险孕妇21例,孕中期检出高风险孕妇31例,其中包括一期高风险孕妇20例,共检出高风险孕妇32例,31例接受了羊膜腔穿刺检查,产前确诊1例,阳性率值为3．2％。32例筛查病例中,30-40岁者16例占（50．00％）,可见高龄孕妇是唐氏综合征的危险人群。当截断值为1：270时,三联筛查与二联筛查对唐氏综合征的检出率均为65．2％;当截断值为1：380时,不同时期二联筛查的检出率明显高于孕中期传统二联法（p〈0．05）o结论：在孕妇不同时期进行二联筛查是更有效的唐氏综合征筛查方法,有必要制定适合本地区人群的风险切割值,以提高产前筛查的筛查效率。     

Improving Hepatitis C Screening in the Primary Care Outpatient Setting for Individuals Belonging to the Birth Cohort 1945-1965

Hepatitis C virus (HCV) affects millions of individuals in the United States. Because of the asymptomatic nature of early illness, many individuals infected with HCV are unaware of their disease status. Measures to increase HCV screening are essential to diagnose early asymptomatic disease, before the onset chronic illness. A quality improvement study was conducted to increase provider awareness of and adherence to HCV screening recommendations. This resulted in an increase in HCV screening among asymptomatic individuals born between 1945 and 1965 (birth cohort 1945-1965). Although this study focused on birth cohort testing, implementation of similar initiatives may increase screening in larger populations.     

口腔癌术前患者营养筛查的研究

目的:调查口腔癌术前患者营养不良及营养风险状况。方法:采用人体测量法、实验室检查法及问卷法对某"三甲"口腔专科医院132例口腔癌术前患者进行营养评定及营养筛查。结果:不同营养评价方法得出患者营养不良发生率不同(1.5%～28.8%),根据营养风险筛查2002(NRS2002)和营养不良筛查工具(MUST)得出营养风险率分别为32.6%、40.9%。以主观全面评定法(SGA)为标准,NRS2002、MUST的灵敏度分别为78.6%、100.0%,特异度分别为72.9%、66.1%,阳性预测值分别为25.6%、25.9%,阴性预测值分别为96.6%、100.0%。根据NRS2002和MUST得出有营养风险的患者的住院时间比没有风险的长(P0.05)。结论:口腔癌术前患者存在不同程度的营养不良和营养风险,建议在口腔癌患者入院时使用NRS2002和MUST进行营养筛查。     

巧用新生儿疾病筛查告知书提高新生儿疾病筛查率简

目的：探讨应用新生儿疾病筛查告知书对提高新生儿疾病筛查率的作用。方法选择2010年10月～2011年9月在我院分娩的1446例新生儿母亲作为对照组,2011年10月～2012年9月在我院分娩的1442例新生儿母亲作为观察组。对照组采取传统的健康教育模式。观察组在对照组基础上结合新生儿疾病筛查告知书进行宣教。比较两组新生儿疾病筛查率。结果观察组新生儿疾病筛查率明显高于对照组,有显著性差异（P＜0．001）。结论应用规范的新生儿疾病筛查告知书,能显著提高新生儿疾病筛查率。     

Nutritional screening and assessment tools for use by nurses: literature review

AIM: This paper reports a literature review describing the range of published tools available for use by nurses to screen or assess nutritional status of patients/clients, and to examine whether the validity, reliability, sensitivity, specificity and acceptability of the tool have been investigated. Tools developed specifically for use with older adults are not considered in this review. A screening/assessment tool is described as a tool that uses a questionnaire-type format, contains more than one risk factor for malnutrition and gives an assessment of risk. BACKGROUND: The incidence of malnutrition in people cared for by nurses is high and screening or assessment tools are often used to identify those with, or at risk of, malnutrition. METHODS: A comprehensive literature review methodology was employed. A range of electronic databases was searched from 1982 to 2002. Search terms incorporating "nutrition", "screening", assessment, feeding, instrument, tool, validity, reliability, sensitivity and specificity were combined. Manual searches were also conducted. RESULTS: Seventy-one nutritional screening/assessment tools were identified of which 35 were reviewed. Tools not reviewed included those which incorporated significant use of biochemical measures (8), included complex anthropometric measures (3), were concerned specifically with ingestion (4) or were designated for use with an older population (21). The tools reviewed use a wide variety of risk factors for malnutrition, varying from anthropometric measurements to socio-cultural aspects of eating behaviour. Some identify an action plan based on the score obtained. Many have not been subjected to validity and/or reliability testing and yet appear to be in use in clinical practice. The sensitivity, specificity and acceptability of the tools are often not investigated. CONCLUSION: There are many published nutritional screening/assessment tools available for use by nurses to screen or assess the nutritional status of patients/clients. Many have not been subject to rigorous testing. Future work should consider a more standardized approach to the use of these tools.     

The use of pooled red cells and column techniques for routine red cell antibody detection

Summary. The object of antibody screening is to detect all clinically relevant antibodies. In order to do this effectively red cells are selected with an appropriate antigen profile. The introduction of column techniques for antibody screening by indirect antiglobulin testing (IAT) and two-stage enzyme testing (ETC) is perceived to lead to an increased sensitivity and an ability to detect red cell antibodies more easily than by traditional tube techniques because reactions in columns are more easily read and are stable. We evaluated the use of a column technology with pooled red cells for routine antenatal screening. The pooled cells used contained at least one cell with homozygous antigen expression for the majority of clinically significant antibodies known to be present, except for Kell. Pooled cell results were not as easy to read in gel columns when compared with single cell results due to weaker reactions which were often diffused throughout the gel in the column. We concluded that the use of pooled cells led to a decreased sensitivity which proved problematic for the interpretation of results. We used a two-cell and a three-cell pool and found that detection of known antibodies was reduced in IAT and ETC methods.     

营养不良通用筛查工具和营养风险筛查2002在炎症性肠病住院患者中应用效果的比较

目的比较营养不良通用筛查工具(malnutrition universal screening tools,MUST)和营养风险筛查2002(nutritional risk screening 2002,NRS2002)在炎症性肠病(inflammatory bowel disease,IBD)住院患者中的应用效果。方法选择2014年1-7月常州市3所三级甲等医院收治的IBD患者93例,分别应用MUST和NRS2002对其进行营养风险筛查并比较。结果MUST和NRS2002对IBD患者的筛查结果显示,两种方法的营养筛查结果一致性较好(Kappa=0.876,P0.001),IBD患者的疾病严重程度与营养风险发生率呈正相关;除TLC外,无或低危营养风险组的身体质量指数、上臂肌围、腹围、肱三头肌皮褶厚度、红蛋白、白蛋白和前白蛋白均高于有或中高危营养风险组,差异均有统计学意义(均P0.01)。结论 MUST和NRS2002对IBD住院患者的营养风险筛查结果有良好的一致性,疾病严重程度与营养风险发生率存在相关性;传统营养指标是筛查IBD住院患者有无营养风险的比较灵敏的指标。