新生儿疾病筛查流程管理效果和筛查结果分析

目的:探讨襄樊市新生儿疾病筛查4个管理模块的运行状况和效果,了解新生儿先天性甲状腺功能低下(CH)和苯丙酮尿症(PKU)的发病情况,进一步提高新生儿疾病筛查的质量水平。方法:对襄樊市2004年～2008年5年出生的84993例新生儿应用细菌抑制法和酶联免疫分析法检测新生儿足跟血滤纸干血斑中苯丙氨酸和促甲状腺素的含量。结果:新生儿疾病筛查率逐步上升。襄樊市市区新生儿疾病筛查率从2004年的92.20%上升到2008年的98.10%,下属县(市)区新生儿疾病筛查率从2004年的12.30%上升到2008年的48.26%。筛查出新生儿先天性甲状腺功能低下39例,发病率为1/2179,苯丙酮尿症5例,发病率为1/16998,治疗随访率均达到100%。结论:4个管理模块运行以后,襄樊市新生儿疾病筛查质量明显提高,患儿的治疗和随访更为及时;但可疑阳性患儿召回和采血员培训工作仍需进一步加强。

Analysis of management effect of screening process of neonatal diseases and screening results

Objective:To explore the operation status and effect of four management modules of neonatal diseases screening,understand the incidences of neonatal congenital hypothyroidism (CH) and phenylketonuria (PKU),improve the quality of neonatal diseases screening.Methods:The levels of phenylalanine and thyrotropin in dry blood maculation of neonatal heel blood of 84 993 neonates born from 2004 to 2008 in Xiangfan city were detected by bacterium inhibiting method and ELISA.Results:The screening rate of neonatal disease increased year by year.The screening rate of neonatal disease in urban areas increased from 92.20% in 2004 to 98.10% in 2008,while the screening rate of neonatal disease in subordinate counties increased from 12.30% in 2004 to 48.26% in 2008.The incidences of CH and PKU were 1/2 179 (39 cases) and 1/16 998 (5 cases),the rates of treatment and follow-up visit reached to 100%.Conclusion:After the operation of four management modules of neonatal diseases screening,the quality of screening increases significantly,the treatment and follow-up visit of the neonates become more prompt;but recalling of probable positive neonates and the training of blood-collecting staff should be further strengthened.