儿童肾瘢痕的发展：管理中的错失机遇。南贝德福德郡从业者小组。
Development of renal scars in children: missed opportunities in management. South Bedfordshire Practitioners' Group.
出版信息
BMJ. 1990 Nov 10;301(6760):1082-4. doi: 10.1136/bmj.301.6760.1082.
OBJECTIVE
To assess the antecedent medical care of children with renal scars.
DESIGN
Retrospective study of both general practice and hospital records.
SETTING
12 Group practices in south Bedfordshire and the radiology and paediatric outpatient departments of a district general hospital.
SUBJECTS
23 Children with renal scars (six boys, 17 girls) from the 12 group practices, identified from outpatient, radiology, and general practice records.
MAIN OUTCOME MEASURES
Number of children in whom a diagnosis of urinary tract infection had been made without prior examination of a mid-stream specimen of urine; number of children who had had a confirmed urinary tract infection that had not been investigated further; number who had experienced delays in investigation or referral; and number who had received inadequate follow up.
RESULTS
In all, 11 of the children had received suboptimal medical care, but the management of the other 12 could not have been better. The most common error was failure to investigate possible urinary tract infections, but follow up of confirmed infections was also inadequate. These problems occurred in hospital as well as in general practice.
CONCLUSION
Opportunities for intervention had been missed in nearly half of this sample of children with renal scars.
目的
评估患有肾瘢痕的儿童之前接受的医疗护理情况。
设计
对全科医疗和医院记录进行回顾性研究。
地点
贝德福德郡南部的12家联合诊所，以及一家地区综合医院的放射科和儿科门诊。
研究对象
从12家联合诊所的门诊、放射科和全科医疗记录中识别出的23名患有肾瘢痕的儿童（6名男孩，17名女孩）。
主要观察指标
在未事先检查中段尿标本的情况下被诊断为尿路感染的儿童数量；确诊为尿路感染但未进一步检查的儿童数量；经历检查或转诊延迟的儿童数量；以及接受随访不足的儿童数量。
结果
总共有11名儿童接受了不理想的医疗护理，但另外12名儿童的护理情况再好不过了。最常见的错误是未能对可能的尿路感染进行检查，但对确诊感染的随访也不足。这些问题在医院和全科医疗中都存在。
结论
在这个患有肾瘢痕的儿童样本中，近一半错失了干预机会。
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