痰液涂片抗酸染色的结果分析[摘要]目的:通过分析结核病患者的痰液涂片镜检结果,了解浏阳市及其周边各乡镇结核病发生情况,改进技术,以提高镜检准确率。方法:1000份样本均来自2017年1月1日至2017年3月31日到浏阳市人民医院呼吸内科、综合科、儿科、感染科等科室就诊并疑似感染的患者,所有患者取痰液标本,实施抗酸染色,采用显微镜进行检测,统计检测结果。结果:在1000份痰液标本当中,检测结果为阳性的有340份,检测阳性率为34.0%;不同时间段和不同性状痰液的标本的阳性检出率存在很大的差异,清晨痰样本是检出率最高的标本,阳性检出率为41.25%,即时痰样本检出率最低,为17.5%,不同时间段痰液标本阳性检出率相比差异具有统计学意义(P<0.05);在不同性状的痰液标本当中,干酪样痰标本阳性检出率最高,达到了57.14%,唾液水样痰标本检出率最低,为2.50%,不同性状痰液标本阳性检出率相比存在明显的差异,具有统计学意义(P<0.05)。结论:对于结核病患者来说,在进行抗结核治疗之前就需要采集患者的痰标本进行涂片检查,这样可以提高阳性检出率,以便及时发现传染源,做好隔离工作。另外,为了提高检测结果的准确性,需要做好痰液标本的质量控制工作。对于不同时间段取样的痰液标本,质量合格的为清晨痰和夜间痰,检出率比较低的为即时痰,不符合样本的质量要求。为充分保证痰液样本检测的质量,可以选择血性样痰和干酪样痰,更有利于做好对结核病的预防和控制工作。关键词:肺结核病;痰液样本;涂片;抗酸染色;发现率[Abstract]Objective:Toanalyzetheresultsofsputumsmearintuberculosispatients,tounderstandtheoccurrenceoftuberculosisinLiuyanganditssurroundingvillages,andtoimprovethetechniquetoimprovetheaccuracyofmicroscopicexamination.Methods:1000sampleswerefromJanuary1,2017toMarch31,2017toLiuyangCityPeople'sHospitalDepartmentofRespiratoryMedicine,GeneralPediatrics,Pediatrics,InfectiousDiseasesandotherdepartmentsandsuspectedinfectedpatients,allpatientstakingsputumspecimens,Theimplementationofacid-resistantstaining,usingamicroscopetodetect,statisticaltestresults.Results:Amongthe1000samplesofsputum,340positivesamplesweredetectedandthepositiveratewas34.0%.Thepositiverateofsputumsamplesindifferenttimeperiodsanddifferenttraitswasverydifferent.(P<0.05).Thepositiverateofsputumsampleswas41.25%,andthedetectionrateofsputumsampleswasthelowest(17.5%).Thepositiverateofsputumsampleswasstatisticallysignificant(P<0.05)Inthesputumsampleswithdifferenttraits,thepositiverateofpositivesampleswas57.14%,thelowestwas2.50%,andthepositivedetectionrateofsputumspecimensofdifferenttraitswasSignificantdifferenceswerestatisticallysignificant(P<0.05).Conclusion:Forpatientswithtuberculosis,intheanti-TBtreatmentbeforetheneedtocollectthepatient'ssputumspecimensforsmear,whichcanimprovethepositivedetectionrate,inordertodetectthesourceofinfection,doisolationwork.Inaddition,inordertoimprovetheaccuracyofthetestresults,needtodoagoodjobofqualitycontrolofsputumspecimens.Fordifferenttimesamplesofsputumsamples,thequalityofqualifiedforthemorningsputumandnightsputum,thedetectionrateisrelativelylowfortheimmediatesputum,doesnotmeetthequalityrequirementsofthesample.Tofullyguaranteethequalityofsputumsampletesting,youcanchoosebloodysputumandcheesesputum,moreconducivetothepreventionandcontroloftuberculosiswork.Keywords:tuberculosis;sputumsample;smear;acidpickling;discoveryrate分枝杆菌的细胞壁内含有大量的脂质,包围在肽聚糖的外面,所以分枝杆菌一般不易着色,要经过加热和延长染色时间来促使其着色。但分枝杆菌中的分枝菌酸与染料结合后,就很难被酸性脱色剂脱色,故名抗酸染色[1-3]。而结核分枝杆菌,是引起结核病的病原菌,可侵犯全身各器官...