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目的评价肺结核患者痰涂片与痰培养检测的临床效果。方法收集1592份痰标本,采用直接涂片萋尼染色法和分枝杆菌分离培养法进行检查,并对结果进行χ2检验,以P<0.05为差异有统计学意义。结果涂片阳性率为11.9%,培养阳性率为12.7%。其中初诊涂阳率为12.8%,培阳率为15.8%;随访患者涂阳率为9.4%,培阳率为4.4%;初诊患者培阳率与涂阳率之间的差异有统计学意义(χ2=4.32,P<0.05)。初诊患者涂阴培阳率为3.7%,涂阳培阴率为0.7%;随访患者涂阴培阳率为2.1%,涂阳培阴率为7.1%,涂阳培阴标本痰菌量为79.5%(31/39)在2+以下,77.4%(24/31)涂阳培阴出现在治疗第2、3月末的痰标本。随访患者涂阳培阴率明显高于初诊患者,差异有统计学意义(χ2=54.93,P<0.01)。培养和涂片联合检出阳性率为15.1%,其中初诊患者阳性率为16.5%,随访患者阳性率为11.5%。结论痰涂片和痰培养联合检测,可以大大提高肺结核患者痰标本中结核杆菌的检出率。
Objective To evaluate the clinical effect of sputum smear and sputum culture in patients with pulmonary tuberculosis. Methods A total of 1592 sputum samples were collected and examined by direct smear staining and Mycobacterium spp. Culture. The results were analyzed byχ2 test. P <0.05 was considered statistically significant. Results The positive rate of smear was 11.9% and the positive rate of culture was 12.7%. Among them, smear positive rate was 12.8% and culture positive rate was 15.8%. The follow-up rate of smear positive rate was 9.4% and rate of positive culture was 4.4%. There was significant difference between rate of smear positive rate and rate of smear positive rate χ2 = 4.32, P <0.05). The prevalence of smear-negative and peptic ulcer in newly diagnosed patients was 3.7%, smear-positive and peptic ulcer was 0.7%. The follow-up of smear-negative and obstetric patients was 2.1%, smear-negative and peptic ulcer was 7.1%, sputum smear-positive sputum was 79.5 % (31/39) below 2+, 77.4% (24/31) of smear positive sputum appeared on the end of the second and third months of sputum samples. Follow-up patients smear yin rate was significantly higher than the newly diagnosed patients, the difference was statistically significant (χ2 = 54.93, P <0.01). The positive rate of culture and smear detection was 15.1%. The positive rate of newly diagnosed patients was 16.5%. The positive rate of follow-up was 11.5%. Conclusion Sputum smear and sputum culture combined detection, can greatly improve the detection rate of tuberculosis bacilli in sputum specimens of patients with pulmonary tuberculosis.