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背景:在大规模结核病控制中,痰涂片阳性检出率低,其原因之一是部分可疑肺结核病人不咳痰、或咳出不合格的痰标本。用高渗盐水超声雾化导痰可获得满意的痰标本,且简单易行。目的:检测超声雾化导痰法对提高结核病人痰涂片阳性检出的实用性。设计:按湖南省地理位置和人口分布选择约60万人口的5个县为研究单位,将连续到县结防所就诊的病人(含初诊和复诊)分成“有痰组”和“无痰组”两组。对“无痰组”病人用10%盐水5ml超声雾化导痰后留取痰标本;对“有痰组”病人分别收集雾化前、后的痰标本进行自身对照,所得每份痰标本各制作厚涂片两张,在显微镜下查找抗酸杆菌。对超声雾化的直接费用进行预算。结果:共2899例(其中1916例初诊病人、983例复诊病人)。受检者通过超声雾化导痰法后获得了满意的痰标本。在1916例初诊可疑肺结核病人中痰涂阳性588例(29.1%),其中“无痰组”738例中痰涂阳性205例(27.8%);在1222例雾化导痰前涂阴病例中,有92例在雾化导痰后获阳性结果。对可疑肺结核病人超声雾化导痰的直接费用进行了分析,每例导痰的平均费用为人民币2.83元,检出每例涂阳病例平均费用为18.32元,结论:高渗盐水超声雾化导痰法是一种有效、价廉、简单易行、能提高痰涂阳性检出率的方法。
BACKGROUND: One of the reasons for the low positive detection rate of sputum smear in large-scale tuberculosis control is that some suspicious TB patients do not expectorate or sputum samples of unacceptable sputum. Sonication with hypertonic saline spray phlegm sputum samples can be satisfactory, and simple and easy. Objective: To detect the utility of ultrasonic atomization and phlegm method to improve the sputum smear positive of tuberculosis patients. Design: According to the geographical location and population distribution of Hunan Province, five counties with about 600,000 population are chosen as the research units, and patients (including the first visit and the second visit) No sputum group “two groups. Sputum specimens were collected after sputum aspiration in 5% sputum with 10% saline on patients without sputum group, and sputum specimens before and after nebulization were collected separately in patients with sputum group. Sputum specimens were made of two thick smear, looking for acid-fast bacilli under the microscope. The direct costs of ultrasonic atomization are budgeted. Results: A total of 2899 cases (of which 1916 cases were newly diagnosed and 983 cases were referred). Subjects obtained satisfactory sputum samples by ultrasonic atomization and phlegm method. Among the 1916 newly diagnosed TB cases, 588 (29.1%) were sputum smear positive, of which 205 (27.8%) were sputum smear positive in 738 cases of ”no sputum group"; in 1222 cases of smear positive sputum In 92 cases, positive results were obtained after nebulization of sputum. The direct costs of ultrasonic atomization and sputum aspiration in suspected pulmonary tuberculosis patients were analyzed. The average cost of conducting sputum in each case was RMB 2.83 yuan. The average cost of smear-positive cases in each case was 18.32 yuan. Conclusion: Phlegm method is an effective, inexpensive, easy to operate, can increase the positive detection rate of sputum smear.