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痰液标本细菌学检验若干问题的探讨
引用本文:杨肇立,周文,陈旭,任萍,李键,李俊如,胡馥生,黄静. 痰液标本细菌学检验若干问题的探讨[J]. 检验医学与临床, 2007, 4(9): 836-838
作者姓名:杨肇立  周文  陈旭  任萍  李键  李俊如  胡馥生  黄静
作者单位:四川省凉山州第一人民医院,四川西昌,615000;四川省凉山州第一人民医院,四川西昌,615000;四川省凉山州第一人民医院,四川西昌,615000;四川省凉山州第一人民医院,四川西昌,615000;四川省凉山州第一人民医院,四川西昌,615000;四川省凉山州第一人民医院,四川西昌,615000;四川省凉山州第一人民医院,四川西昌,615000;四川省凉山州第一人民医院,四川西昌,615000
摘    要:目的 促进痰液细菌学检验技术规范的建立.方法 对痰液标本细菌学检验全过程的主要环节进行实验探索和认真观察.结果 痰液标本"前处理"问题值得商讨,"认真选取病理成分"较为适用.一般细菌培养,宜同时选用血平板和巧克力平板.细菌培养和直接涂片革兰染色镜检宜同时进行.倡导常规化半定量培养方式,试用"12级法".对于"自然咯痰"法采集的标本,其感染菌的实验室判定,应当依据临床痰液标本细菌学检验结果和当地各年龄段"健康人群"口咽部分泌物的细菌半定量调查结果的相互比较:如果"正常菌群"的数量大于上述调查结果的平均携带量而小于2倍平均携带量,可视为增多,有可能是"感染菌",但可能性较小;若数量大于上述调查结果的2倍平均携带量,可视为明显增多,更有可能是"感染菌",而且可能性较大.感染的最终诊断,只能由临床医生综合各方面信息之后作出.结论 痰液标本质量具有决定性作用,应规定由医务人员当面指导和监督取送.微生物学检验工作者应密切联系患者和医护人员;微生物学检验报告应常规化设置"检验咨询"栏目.

关 键 词:痰液  细菌学  检验
文章编号:1672-9455(2007)09-836-03
修稿时间:2007-04-23

Study on several problems in bacteriological examination of the sputum specimen
YANG Zhao-li, ZHOU Wen, CHEN Xu,et al.. Study on several problems in bacteriological examination of the sputum specimen[J]. Laboratory Medicine and Clinic, 2007, 4(9): 836-838
Authors:YANG Zhao-li   ZHOU Wen   CHEN Xu  et al.
Affiliation:YANG Zhao-li, ZHOU Wen, CHEN Xu, et al.
Abstract:Objective To accelerate the establishment of "the Technical Norm of the Bacteriological Examination of the Sputum" and to promote the progress of microbiological examination business through this study.Methods The main steps during bacteriological examination of the sputum specimen was surveyed and analyzed.Results Pre-processing of sputum specimen should be emphasized. The sputum specimen should be collected and delivered under the guidance and supervision of medical staff because of its decisive effects on the examination quality. "Selecting pathological components" was available. During the process of general bacterial culture, haematoporphyrin and chocolate plates were needed at the same time. The bacterial culture and the direct smear of bacteria should be carried out simultaneously. The conventional semi-quantitative culture modus shoule be advocated. Try to use 12-order method. For the sputum specimen collected by using the method of "natural stethocatharsis", the laboratory assessment of its infected bacteria should be based on the comparison between the bacteriological examination results of clinical sputum specimen and the bacteriological semi-quantitative culture results of oropharynx secretion within the local "healthy people" with different ages. If the number of "normal flora" was larger than the average but smaller than twice the average in the above investigation, the bacteria might be regarded as "increased" and "infected bacteria" with lower possibility; if the number was larger than twice the average, the bacteria might be regarded as "increased tremendously" and "infectious bacteria" with higher possibility. The final diagnosis of infection should only be made by clinical doctors after analyzing all information.Conclusion Microbiological examiner should often contact patients and medical staff and the counseling about microbiological examining report should be established.
Keywords:sputum specimen  bacteriology  examination
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