矮小身材儿童预防性筛查和临床治疗路径管理方案的探索

Study on administrative pathway combining preventive screening and clinical practice for short stature children

目的结合预防保健和临床治疗相结合路径管理理念,探讨一种结合矮小身材儿童的人群常规筛查、儿科检查、确诊、病因分析、治疗程序和随访的管理路径的方案,为进一步提高矮小身材儿童治疗效率。方法本文回顾性分析大同市某幼儿园、小学儿童身高体检资料以及同煤总医院儿科的矮小身材儿童的身高检查、诊断和治疗的资料。结果参照2005年9省/市儿童体格发育调查数据研究制定的中国2~18岁儿童身高标准,本研究所选观察人群的矮小身材儿童的发病情况与国内其他地区相近;在临床就诊儿童中,确诊为矮小身材的占66%,而有27.2%的儿童生长缓慢,其余为未达到矮小身材的标准,归为身材偏小,有6.8%的为正常。继续随访观察,矮小身材和身材偏小的儿童中,分别只有29.3%和25%的家庭愿意接受治疗。结论结合已发表的研究结果,提出儿童的人群常规筛查、儿科临床检查、确诊、治疗和护理的一条龙路径的管理方案,以提高矮小症的诊治率。

Objective The short stature is the most common endocrine disorder in pediatrics. Three percent of children suffered from this disease. However, only one from ten such children is under clinical care. So, this study is to explore an administrative pathway combining preventive screening and clinical practice for short stature children, in order to further improve the efficiency in children＇s short stature therapy. Methods The present study used and analyzed data were from a kindergarten and primary school in Datong City as well as those from published data. Results Refer to the criterion from the national survey of physical development of children in nine cities in 2005, this investigation indicated that the prevalence of short statue was similar with that in other regions. In all clinic visitors for this reason, 66% were diagnosed as short statue, 27.2% were shorter statue, going to follow-up observation. Only 29.3% of short statue children were willing to take medication. Based on these results and published literature, we put forward a procedure for an administrative pathway Conclusion The administrative pathway of preventive screening, diagnosis, treatment and nursing is put forward for short stature children.