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首页> 外文期刊>Open Journal of Respiratory Diseases >Value of Repeated Direct Smear Sputum Examination in the Diagnosis of Pulmonary Tuberculosis
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Value of Repeated Direct Smear Sputum Examination in the Diagnosis of Pulmonary Tuberculosis

机译：重复直接涂片痰液检查在肺结核诊断中的价值

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Introduction: The examination of three sputum samples per suspect has been severely criticized from a public health viewpoint and several recent trials have documented the relative inefficiency of the third smear and the necessity for confirmation of a positive smear has also been contested. Aim: This study, undertaken in Qena, Egypt, aimed to determine the usefulness of examining the second and third direct smear microscopy (DSM) specimen in the diagnosis of pulmonary TB. Patients and methods: A retrospective study using record review at TB outpatient clinic; Qena Chest Hospital, Egypt, was done from 2010-2013. Direct smear results were collected as one of the following combinations PNN, PPP, PPN, PNP, NNP, NPP, and NPN, NNN, where N is a negative and P a positive smear. The proportion of positive, first, second and third specimen were calculated. Cases were considered positive having at least one positive smear confirmed by another positive one in the absence of sputum culture. Results: Out of 9420 recorded suspects, 719 of them were positive, so smear positivity was 7.6%. The majority of them were diagnosed from the first sample (96.4%). For only 3.6% (26 of 719), the second smear was positive and a third specimen was required (NPP) to make a definitive diagnosis of TB. No recorded isolated positive or negative smears in the third sample (NNP or PPN). Conclusions: These data indicated that, in our locality with limited financial resources, the incremental yield of a second sputum direct smear examination was low, and the third one was negligible indicating that examination of two sputum samples is enough among pulmonary TB patients. A third sample is required only as confirmatory if the second sample was positive. Smear microscopy can be substantially simplified with favourable resource implications.
机译：简介：从公共卫生角度严厉批评了每名嫌疑人对三个痰标本的检查，最近的一些试验证明，第三次涂片相对无效，也有人质疑确认阳性涂片的必要性。目的：该研究在埃及的Qena进行，旨在确定检查第二和第三直接涂片显微镜（DSM）标本在诊断肺结核中的有用性。患者和方法：在结核病门诊进行回顾性研究。埃及Qena胸腔医院于2010年至2013年成立。直接涂片结果是以下PNN，PPP，PPN，PNP，NNP，NPP和NPN，NNN组合之一，其中N为阴性，P为阳性涂片。计算阳性，第一，第二和第三样本的比例。在不进行痰培养的情况下，至少有一个阳性涂片被另一例阳性涂片确认为阳性病例。结果：在记录的9420名犯罪嫌疑人中，有719名呈阳性，涂片阳性率为7.6％。其中大多数是从第一个样本中诊断出来的（96.4％）。仅3.6％（719例中的26例），第二次涂片呈阳性，需要第三份标本（NPP）才能明确诊断结核病。在第三个样本（NNP或PPN）中没有记录到孤立的阳性或阴性涂片。结论：这些数据表明，在我们财政资源有限的地区，第二次痰液直接涂片检查的增幅较低，而第三次痰液涂片检查的结果可忽略不计，表明对肺结核患者进行两次痰液样本检查就足够了。如果第二个样品为阳性，则仅需要第三个样品作为确认。涂片显微镜可以大大简化，并带来有利的资源影响。

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