摘要
目的分析结核病控制规划实施过程中痰涂片染色抗酸菌检查工作的现状,探讨影响检测质量的可能因素,以持续改进和不断完善相应措施,快速提高结核病诊疗与防控水平。方法回顾性分析广州市结核病防治所越秀区2006—2015年、海珠区2018—2019年《广州市结核病控制项目初诊患者登记本》登记资料。结果在册登记11742例可疑结核病患者,其中结核病患者5989例、痰涂片抗酸菌检查阳性者1970例(占结核病患者的32.89%)。结核病患者3个送检涂片样本中全部阳性、2个样本阳性、1个样本阳性、全部阴性的分别有1481例(24.73%)、284例(4.74%)、205例(3.42%)和4019例(67.11%)。以就诊时间和痰涂片检查报告时间间隔,将患者样本分为时间间隔为0 d的至少2个即时痰的“A组”和时间间隔≥1 d可能包括晨痰、夜间痰、及时痰的“B组”,在可获得时间间隔资料的2147例患者中,A组、B组病例分别为406例和1741例,A组占比18.91%。其中:临床诊断结核病患者1149例(A组185例、B组964例),痰涂片抗酸菌检查阳性509例(44.30%),A组、B组患者3个送检涂片样本中全部阳性、2个样本阳性、1个样本阳性、全部阴性的分别有70例(37.83%)、14例(7.56%)、17例(9.19%)、84例(45.41%)和303例(31.43%)、53例(5.50%)、52例(5.39%)、556例(57.60%),B组阳性率显著低于A组(χ2=9.4718,P<0.05)。结论在结核病临床诊疗与防控实践中,宣教和督促患者按“即时痰”“夜间痰”和“晨痰”规范留取样本并及时送检的工作力度有待加强,以提高涂片染色抗酸菌检查的阳性检出率。
Objective To continuously improve measures and level of tuberculosis diagnosis,treatment,and prevention by analyzing the current status of sputum smear staining for acid-fast bacteria in the process of the implementation of the tuberculosis prevention and control plan and by exploring the possible factors affecting test quality.Methods The registration data of Yuexiu District between 2006 and 2015 and of Haizhu District between 2018 and 2019 from the Registration Book for Newly Diagnosed Patients of the Guangzhou Tuberculosis Control Project were retrospectively analyzed.Results 5989 cases were diagnosed as pulmonary tuberculosis from the 11742 registered cases with suspected tuberculosis;of which,1970 patients,accounting for 33.16%,were positive in sputum smear staining for acid-fast bacteria.Among the patients with pulmonary tuberculosis,1481(24.73%)were positive in all the samples,284(4.74%)in 2,and 205(3.42%)in 1,and 4019(67.11%)were negative in all the 3.According to the time interval between patient consultation and test report,the csaes were divided into group A of at least two sputums processed at a convenient time with an interval of zero day and group B possibly including morning sputum,night sputum,and sputums at a convenient time with an interval≥1 d.Among the 2147 cases whose data of time interval were available,there were 406 cases in group A,accounting for 18.91%,and 1741 cases in group B.Among the 2147 cases,1149 patients were with pulmonary tuberculosis,including 185 cases in group A and 964 cases in group B,and 509 patients were positive in sputum smear staining for acid-fast bacteria.70 case(37.83%)were positive in all the 3 samples,14(7.56%)in 2,and 17(9.19%)in 1,and 84(45.41%)were negative in all the 3 samples in group A;and 303(31.43%),53(5.50%),52(5.39%),and 556(57.60%)in group B;the positive rate was significantly lower in group B than in group A(χ2=9.4718,P<0.05).Conclusion In the process of the implementation of clinical diagnosis,treatment,prevention and control of tuberculosis,the w
作者
许婉华
刘玉美
伍小英
刘国标
黄业伦
李华
刘志辉
刘健雄
Xu Wanhua;Liu Yumei;Wu Xiaoying;Liu Guobiao;Huang Yelun;Li Hua;Liu Zhihui;Liu Jianxiong(Guangzhou Chest Hospital,Guangzhou 510095,China)
出处
《国际医药卫生导报》
2020年第12期1655-1657,共3页
International Medicine and Health Guidance News
基金
“艾滋病和病毒性肝炎等重大传染病防治”国家科技重大专项(2018ZX10715004)
广东省转化医学创新平台建设项目(省卫函[2018]1254号)
广州市高水平临床重点专科和培育专科建设项目(穗卫函[2019]155号)。
关键词
肺结核
涂片染色抗酸菌检查
质量管理
Lung tuberculosis
Smear staining test for acid-fast bacteria
Quality control
