Riobó P, Walker R, Sanz T, Plaza P, Olalla T, Gómez P, Muñoz F, Monge V
Servicio de Medicina Preventiva, Hospital Ramón y Cajal, Madrid.
Rev Clin Esp. 1992 Apr;190(7):361-6.
A literature search has been made on the examinations to be performed during the "periodic health exam" on the healthy adult. These examinations shall be performed bearing in mind the prevalence and morbility data of the specific diseases, individual risk factors and the quality (sensibility and specificity) of the diagnostic procedure. The value of regular blood pressure determination, breast exam and cervical cytology with Papanicolaou stain, is well established. However, there is no consensus regarding other determinations, due to the fact that different authors use different approaches. The skin, mouth and thyroid examination for cancer screening is limited only to individuals having risk factors. Heart auscultation for the diagnosis of valvulopathies that could required antibiotic prophylaxis for bacterial endocarditis is important. In individuals over sixty years old, vision acuity and hearing capabilities should be explored, also abdomen should be explored to detect aortic aneurysms. Hypercholesterolemia should be determined in individuals over 20 years old, and PPD should be performed before 35 years old. Concerning the rest of explorations (rectal taction, testicular exploration, etc.) its efficacy has not been clearly established in the screening.
已针对健康成年人“定期健康检查”期间应进行的检查开展了文献检索。进行这些检查时应考虑特定疾病的患病率和发病率数据、个体风险因素以及诊断程序的质量(敏感性和特异性)。定期测量血压、乳房检查以及巴氏染色宫颈细胞学检查的价值已得到充分确立。然而,对于其他检查尚无共识,因为不同作者采用不同方法。皮肤、口腔和甲状腺癌筛查检查仅适用于有风险因素的个体。心脏听诊对于诊断可能需要预防性使用抗生素以预防细菌性心内膜炎的瓣膜病很重要。对于60岁以上的个体,应检查视力和听力,还应检查腹部以检测主动脉瘤。应在20岁以上的个体中测定高胆固醇血症,结核菌素试验应在35岁之前进行。关于其他检查(直肠指检、睾丸检查等),其在筛查中的有效性尚未明确确立。