Hostetter M K, Iverson S, Dole K, Johnson D
Department of Pediatrics, University of Minnesota, Minneapolis.
Pediatrics. 1989 Apr;83(4):559-64.
Seven simple screening tests--hepatitis B profile, urine culture for cytomegalovirus, Mantoux test for tuberculosis, stool examination for ova and parasites, VDRL, complete blood cell count, and vision and hearing screening--were used to evaluate 52 consecutive children at a pediatric clinic for international adoptees. In 63% of these children, unsuspected medical diagnoses were made by a combination of history, physical examination, and appropriate screening tests. When only those children previously examined by a physician in the United States were included in our analysis, the rate of unsuspected diagnosis remained high (67%). Omission of screening tests was the single most frequent cause of missed diagnoses, of which the majority were infectious diseases. More than 50% of our newly established diagnoses carried the potential for long-term sequelae without proper treatment. These data emphasize that internationally adopted children should receive a thorough screening evaluation for medical problems that may adversely affect their growth and development.
七项简单的筛查测试——乙肝五项、巨细胞病毒尿培养、结核菌素试验、粪便虫卵和寄生虫检查、性病研究实验室试验、全血细胞计数以及视力和听力筛查——被用于评估一家儿科诊所连续收治的52名国际领养儿童。在这些儿童中，63%通过病史、体格检查和适当的筛查测试组合得出了意外的医学诊断。当我们的分析仅纳入那些之前在美国接受过医生检查的儿童时，意外诊断率仍然很高（67%）。遗漏筛查测试是漏诊的最常见单一原因，其中大多数是传染病。我们新确诊的病例中，超过50%若未得到妥善治疗可能会导致长期后遗症。这些数据强调，国际领养儿童应接受全面的筛查评估，以排查可能对其生长发育产生不利影响的医学问题。
