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目的研究粪便涂片在诊断腹泻患儿肠道菌群失调中的临床意义。方法回顾性分析2014年7月至8月徐州市儿童医院收治的576例腹泻儿童的临床资料,对所有患儿粪便均进行革兰染色涂片镜检及粪便常规检查,配合问卷调查收集基本信息。结果 576例腹泻患儿粪便涂片中有480例(83.3%)发生肠道菌群失调,其中I度肠道菌群失调230例(47.9%);Ⅱ度肠道菌群失调166例(34.6%);Ⅲ度肠道菌群失调84例(17.5%)。使用过抗生素的患儿均发生肠道菌群失调,且46例粪便涂片中发现真菌。肠道菌群失调的涂片中优势菌为G+球菌352例(73.3%),球菌与杆菌比例倒置,大致为73∶27。结论腹泻患儿存在不同程度肠道菌群失调,特别是在使用抗生素的患儿中。粪便涂片镜检是一种观察肠道菌群失调的快捷且简便的方法,可为临床诊断患儿肠道菌群失调、避免滥用抗生素、指导儿童腹泻的治疗提供依据。尤其适用于门诊及基层医疗机构儿童腹泻的诊治。
Objective To study the clinical significance of stool smear in the diagnosis of intestinal flora in children with diarrhea. Methods The clinical data of 576 children with diarrhea treated in Xuzhou Children’s Hospital from July to August 2014 were retrospectively analyzed. Gram stain smear and routine examination of stools were performed on all the stools of children, and questionnaires were collected to collect basic information . Results Among 576 cases of diarrhea, there were 480 cases (83.3%) of intestinal mucosal dysplasia, among which 230 cases (47.9%) had I degree intestinal flora imbalance, and 166 cases (34.6% %); Ⅲ degree intestinal flora dysfunction in 84 cases (17.5%). Intestinal microbiota occurred in children with antibiotics, and fungi were found in 46 stool smears. Gut microflora in intestinal flora dominant bacterium was G + cocci 352 cases (73.3%), the ratio of cocci and bacilli inversions, roughly 73:27. Conclusion There are different degrees of intestinal flora in children with diarrhea, especially in children with antibiotics. Stool smear microscopy is a quick and easy way to observe the imbalance of gut microbiota. It can provide a basis for clinical diagnosis of intestinal flora in children, abusing antibiotics and guiding the treatment of diarrhea in children. Especially for outpatient and primary care institutions for diagnosis and treatment of children’s diarrhea.