Ngama M J, Ouma B, English M E, Nokes D J
Kenya Medical Research Institute, Centre for Geographic Medicine Research (Coast), Kilifi, Kenya.
East Afr Med J. 2004 Jun;81(6):313-7. doi: 10.4314/eamj.v81i6.9181.
Nasopharyngeal aspiration (NPA) is used widely in the collection of nasal specimens for respiratory virus diagnosis. The method has limitations in relation to technical expertise, patient anxiety, and apparatus dependence. Nasal washing (NW) offers an alternative approach.
To identify the merits of two different NW methods in comparison with NPA.
Two hundred children with acute respiratory infection (ARI) were randomised to receive one of three collection devices: (i) standard NPA, (ii) NW using a 30ml ear-syringe bulb (NWb), or (iii) NW using a 5ml syringe (NWs) with a shortened (9cm) 8FG tube. Assessment focused on ease of procedure, acceptability to parent and child, and adequacy of epithelial cell yield for immunofluorescence testing. A short questionnaire was delivered.
Paediatric Ward of Kilifi District Hospital, (KDH) Kilifi, Kenya.
Any child admitted with ARI between 5th November 2001 and 24th January 2002.
Children recruited into NPA, NWb and NWs procedures numbered 62, 76 and 62, respectively (median age of 8 months). A higher proportion of children receiving NWb did not cry (43%) compared to those receiving NPA (13%) (OR 5.18; 95% CI 2.17-12.4). Whereas 66% of mothers were comfortable with NPA procedure, the proportion for NWs was 40% (OR 0.341; 0.163-0.714). Acceptability to the operator was marginally lower for NWs than NPA (79% vs 92%, OR 0.324, 0.107-0.974). For other observations there were no differences between the procedures; these were length of procedure (98% <5mins), the acceptable time interval for repeating a procedure (64% <1 week), comparison with blood collection (77% preferred the nasal specimen) and slides with 20 or more epithelial cells (overall 82%).
Nasal washing methods provide simple and effective alternatives to NPA, with the NWb being the more acceptable, and have merits for use in resource poor and home settings.
鼻咽抽吸术（NPA）广泛用于采集鼻标本以诊断呼吸道病毒。该方法在技术专业要求、患者焦虑程度和设备依赖性方面存在局限性。鼻腔冲洗（NW）提供了一种替代方法。
比较两种不同的鼻腔冲洗方法与鼻咽抽吸术的优点。
200名急性呼吸道感染（ARI）儿童被随机分配接受三种采集设备中的一种：（i）标准鼻咽抽吸术，（ii）使用30毫升耳用注射器球囊进行鼻腔冲洗（NWb），或（iii）使用配有缩短（9厘米）8FG管的5毫升注射器进行鼻腔冲洗（NWs）。评估重点在于操作的简易程度、家长和儿童的接受度以及用于免疫荧光检测的上皮细胞产量是否充足。发放了一份简短问卷。
肯尼亚基利菲区基利菲区医院儿科病房（KDH）。
2001年11月5日至2002年1月24日期间因急性呼吸道感染入院的任何儿童。
接受鼻咽抽吸术、NWb和NWs操作的儿童分别为62名、76名和62名（中位年龄8个月）。与接受鼻咽抽吸术的儿童（13%）相比，接受NWb的儿童中不哭的比例更高（43%）（比值比5.18；95%置信区间2.17 - 12.4）。66%的母亲对鼻咽抽吸术操作感到放心，而对NWs感到放心的比例为40%（比值比0.341；0.163 - 0.714）。NWs对操作人员的可接受性略低于鼻咽抽吸术（79%对92%，比值比0.324，0.107 - 0.974）。对于其他观察指标，各操作之间没有差异；这些指标包括操作时间（98%＜5分钟）、重复操作的可接受时间间隔（64%＜1周）、与采血的比较（77%更喜欢鼻标本）以及含有20个或更多上皮细胞的玻片（总体为82%）。
鼻腔冲洗方法为鼻咽抽吸术提供了简单有效的替代方法，其中NWb更易被接受，且在资源匮乏和家庭环境中使用具有优点。
