结核病与肺部健康杂志 ›› 2014, Vol. 3 ›› Issue (2): 124-127.doi: 10.3969/j.issn.2095-3755.2014.02.011

• 论著 • 上一篇    下一篇

护理干预对结核病患者痰标本留取质量影响的研究

高燕波, 高翠南, 许卓卫, 舒扬, 周琳   

  1. 510630 广州,广东省结核病控制中心防治科(高燕波、舒扬),中心主任办公室(周琳);广州市胸科医院结核病防治第一门诊诊疗科(高翠南、许卓卫)
  • 收稿日期:2014-03-19 出版日期:2014-04-20 发布日期:2014-04-20
  • 通信作者: 高翠南,Email:gaocuinan@163.com;周琳,Email:gdtb_bg@vip.163.com
  • 基金资助:
    广东省医学科研基金(A2009115);“十二五”国家科技重大专项(2012ZX10004903)

Impact of nursing intervention on sputum specimen quality of tuberculosis patients

GAO Yan-bo*, GAO Cui-nan, XU Zhuo-wei, SHU Yang, ZHOU Lin.   

  1. Centre for Tuberculosis Control of Guangdong Province, Guangzhou 510630, China
  • Received:2014-03-19 Online:2014-04-20 Published:2014-04-20
  • Contact: GAO Cui-nan,Email: gaocuinan@163.com; ZHOU Lin, Email: gdtb_bg@vip.163.com

摘要: 目的 通过护理干预对结核病患者痰标本留取质量影响的研究,探讨提高结核病门诊患者痰标本留取质量的护理干预措施。方法 对广州市胸科医院结核病防治第一门诊和广东省结核病控制中心门诊在2011年12月至2013年1月门诊就诊的1105例就诊的疑似肺结核和确诊的肺结核患者,采用随机方法(按门诊患者就诊自然序号,单数为研究组,双号为对照组,直到两组选满患者为止)将患者分为对照组和研究组,其中对照组496例,研究组609例。对照组患者采用自己留痰后送检的方法;研究组患者根据医嘱护士在患者留取痰标本前给予护理指导和干预后留痰送检。然后评价两组患者的痰标本留取的质量和结核分枝杆菌的痰涂片阳性检出率。结果 对照组送检的496份标本中,合格标本412份,合格率83.1%;其中阳性检出标本130份,阳性率26.2%。研究组送检的609份标本中,合格标本579份,合格率95.1%;其中阳性检出标本207份,阳性率34.0%。研究组送检标本的合格率和阳性检出率明显高于对照组,两组差异有显著统计学意义(χ2值分别为42.6、7.81,P值均<0.01)。对照组标本中涂片“+”的阳性检出构成比为19.2% (25/130);研究组标本中涂片“+”的阳性检出构成比为29.0% (29/207),对照组标本中涂片“+”的阳性检出构成比显著低于研究组,两组差异有统计学意义(χ2=4.03,P<0.05)。结论 做好结核病患者留取痰标本前的护理指导和干预工作能够提高患者送检痰标本的合格率,同时能提高痰标本的阳性检出率;特别能够多发现那些病变轻、排菌量少的肺结核患者,减少涂阳肺结核患者的漏诊。

Abstract: Objective sTo evaluate the impact of nursing intervention on sputum specimen quality of tuberculosis (TB) patients, and to explore new nursing intervention methods to improve the sputum specimen quality.Methods A total of 1105 TB suspects or patients were registered in the Guangzhou Chest-Disease Hospital or Guangdong TB Control Center from Dec.2011 to Jan. 2013. According to the visit number, the subjects were divided into study and control groups randomly. 496 patients in control group collected the sputum specimen by themselves and 609 patients in study group were trained how to collect the sputum specimen by the nurses. The quality of sputum specimens and the detection rate of Mycobacterium tuberculosis were compared.Results There were 412 qualified sputum specimens in control group and the qualification rate was 83.1% (412/496), 130 positive sputum specimens were detected and the positive detection rate was 26.2%. In study group there were 579 qualified sputum specimens and the qualification rate was 95.1% (579/609), 207 positive sputum specimens were detected and the positive detection rate was 34.0%. There were significant difference between the two groups in sputum specimen qualification rate and the positive detection rate (χ2=42.6 and 7.81, P<0.01). The AFB (+) proportion was 19.2% (25/130) and 29.0% (29/207) respectively between control group and study group, and that of the control group was lower than the study group (χ2=4.03, P<0.05).Conclusion The nursing intervention can improve the quality of sputum specimen of TB patients and the positive detection rate can be improved as well. The nursing intervention can especially improve the positive detection rate of those with light lesion and little discharge of bacteria, and can reduce the misdiagnosis of smear positive TB cases.