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洗胃在无法咳痰患者结核病诊断中的应用价值

Utility of Gastric Lavage for Diagnosis of Tuberculosis in Patients who are Unable to Expectorate Sputum.

作者信息

Baghaei Parvaneh, Tabarsi Payam, Farnia Parisa, Radaei Amir Hoseyn, Kazempour Mehdi, Faghani Yazdan Ali, Mirsaeidi Mehdi, Novin Atieh, Chitsaz Ehsan, Mansouri Davoud, Masjedi Mohammad Reza, Velayati Ali Akbar

机构信息

Clinical Tuberculosis and Epidemiology Research Center, N. R. I. T. L. D, Masih Daneshvari Hospital, Shaheed Beheshti University of Medical Science and Health Services, Tehran, Iran.

出版信息

J Glob Infect Dis. 2011 Oct;3(4):339-43. doi: 10.4103/0974-777X.91054.

Abstract

BACKGROUND

There are number of patients who are unable to expectorate sputum specimens. In this study, we used gastric lavage (GL) test for diagnosis of tuberculosis (TB) in patients who were unable to produce sputum.

MATERIALS AND METHODS

Patients who were unable to produce sputum specimens were included in the study to confirm TB disease. Gastric lavage sampling was performed and sent for acid fast bacillus smear and culture under special laboratory conditions and sterilized methods. Further bronchoscopy for broncho-alveolar lavage was done on patients with negative GL smear results. Drug susceptibility tests were performed on 48 GL culture positive cases.

RESULTS

Eighty-five patients were included in the study; who were hospitalized at our referral center for suspected TB. GL smears were reported to be positive in 37 cases (66.07%) and culture in 85.7%. The total number of smear and culture-positive cases in this study was 48 (85.7%). Forty cases (87%) of drug-sensitive, 1 case (2.2%) of isoniazid and rifampin-resistant TB (multi-drug resistant; MDR), and 5 cases of resistant to one drug were detected. There have not been observed any complications after the GL method.

CONCLUSION

It seems that regarding the high number of positive GL cultures (85.7%), GL can be effective for diagnosis of patients who have suspicious tuberculosis symptoms and are unable to produce sputum especially in resource limited areas.

摘要

背景

有许多患者无法咳出痰标本。在本研究中,我们对无法咳痰的患者采用洗胃(GL)试验来诊断结核病(TB)。

材料与方法

无法咳出痰标本的患者被纳入研究以确诊结核病。进行洗胃采样,并在特殊实验室条件和无菌方法下送检进行抗酸杆菌涂片和培养。对GL涂片结果为阴性的患者进一步进行支气管镜肺泡灌洗。对48例GL培养阳性病例进行药敏试验。

结果

85例患者被纳入研究,他们因疑似结核病在我们的转诊中心住院。GL涂片报告阳性37例(66.07%),培养阳性率为85.7%。本研究中涂片和培养均阳性的病例总数为48例(85.7%)。检测到40例(87%)药物敏感,1例(2.2%)异烟肼和利福平耐药结核病(耐多药;MDR),以及5例对一种药物耐药。GL方法后未观察到任何并发症。

结论

鉴于GL培养阳性率高(85.7%),GL似乎对有可疑结核症状且无法咳痰的患者的诊断有效,尤其是在资源有限的地区。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/afe4/3249987/7e49b34f5a78/JGID-3-339-g001.jpg

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