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地点:喀麦隆西北部的圣伊丽莎白医院,此地区结核病(TB)发病率和人类免疫缺陷病毒(HIV)的感染率都很高。目的:测量日常痰涂片显微镜检查的时间,并评价多花10分钟进行复检能否提高涂阳病人的检出率。设计:这项为期6个月的前瞻性观察研究包括3个内容:1)测量日常痰涂片显微镜检查的时间;2)对所有涂片进行10分钟的盲法复检,并与原结果进行对比;3)将假阴性和真阴性涂片按比例混合后,由原镜检者进行10分钟的盲法复检。结果:总共有204名病人612份痰标本送检。日常镜检时间中位数为2分6秒(1分30秒——2分30秒)。10分钟复检将涂阳标本从82份提高到116份 (P=0.0083),病例检出从28人增加到48人(P=0.011)。经过10分钟复检程序,原镜检人员将一半以上的假阴性涂片纠正为阳性。结论:太快的痰涂片显微镜检查敏感性低,10分钟附件显著增加病例检出。保证推荐的镜检时间是提高病例检出简单廉价的方法。
Where: St. Elizabeth Hospital in northwestern Cameroon, where tuberculosis (TB) incidence and the human immunodeficiency virus (HIV) prevalence are high. OBJECTIVE: To measure the time of daily sputum smear microscopy and to evaluate whether the rate of smear-positive patients can be increased by re-examinations at the same time. Design: This 6-month prospective observational study includes three components: 1) measuring daily sputum smear microscopy; 2) 10-minute blind retest of all smears performed with the original results Contrast; 3) The false negative and true negative smear mixed in proportion, by the original mirror for 10 minutes of blind retest. RESULTS: A total of 612 sputum specimens from 204 patients were submitted for screening. The median daily examination time was 2 minutes 6 seconds (1 minute 30 seconds - 2 minutes 30 seconds). The 10-minute review increased smear positive samples from 82 to 116 (P = 0.0083), and the number of cases detected increased from 28 to 48 (P = 0.011). After 10 minutes of re-examination procedures, the original inspection staff will be more than half of the false-negative smear correct. CONCLUSIONS: Sputum smear microscopy is too sensitive and has a significantly increased attachment at 10 minutes. Ensuring the recommended microscopic examination time is a simple and inexpensive way to increase detection of cases.