痰标本的送检条件与病原菌检出率的相关性研究

The study of correlation to the sending condition of Sputum samples and the incidence rate of pathogen

目的:研究临床痰标本的合格率。方法:利用前瞻性和双盲调查法。采用痰细菌培养标本直接涂片、革兰染色、显微镜检查评价痰标本的质量。调查痰标本的镜检合格率、转运时间、标本采集情况否满足晨痰、深咳、漱口三个条件。分别计算不同条件下痰标本需氧菌分离率。结果:患者留取痰标本满足漱口、晨痰、深咳三个条件者需氧菌分离率明显高于未满足这三个条件者。需氧菌分离阳性的痰标本平均转运时间为46min,需氧菌分离阴性痰标本平均转运时间为75min。转运时间在1h内的痰标本需氧菌分离率明显高于超过1h者。痰标本涂片镜检中性白细胞>10/LP,鳞状上皮细胞<25/LP者需氧菌分离率明显高于中性白细胞<10/LP,鳞状上皮细胞>25/LP者;有柱状上皮细胞存在的痰标本需氧菌分离率高、痰标本涂片镜检的结果与需氧菌分离结果的符合率高。结论:满足晨痰、深咳、漱口三个条件,在1h内送检的痰标本,有助于提高需氧菌分离率。根据涂片镜检中性白细胞和鳞状上皮细胞数量评价痰培养标本的可接受性有助于选择恰当的培养方法,提高细菌分离阳性率。

Objective： To sample the qualification rate of sputum specimen.Methods： The specimen collecting and delivering time,whether or not morning,deep cough and gargling of sputum specimen was investigated.Aerobic bacteria isolated rate was evaluated.Results：The mean de- livering time in positive aerobic bacteria isolated specimens and negative aerobic bacteria isolated specimens was46min and75min respec- tively.Aerobie bacteria isolated rate is higher in neutrthan in neutrophils〈10FLP and squamous epithelial cells〉25/LP. Conelusion：Lower res- piratory tract specimens should be delivered to the laboratory withinlhour.Sputum specimen should be collected in the morning and with deep cough and gargling.Screening of sputum by Gram staining is a routine and accepted practice.