粪便涂片检查在诊断肠道菌群失调中的临床意义  

Clinical Significance of Fecal Smear Examination on Diagnosing Intestinal Flora Imbalance

作　　者：王晓明[1] 赵瑞芹[1] 辛素霞[1] 宋红娥[1] 郭映晖[2] 白革兰[1] 

机构地区：[1]河北省儿童医院消化科,石家庄050031 [2]河北省儿童医院细菌室,石家庄050031

出　　处：《实用儿科临床杂志》2007年第7期492-493,共2页Journal of Applied Clinical Pediatrics

基　　金：河北省2003年医学科学研究重点课题计划项目资助(03202)

摘　　要：目的研究婴幼儿腹泻粪便涂片检查在诊断肠道菌群失调的临床意义。方法用无菌器皿留取患儿新鲜粪便适量,取无菌棉签在洁净的载玻片上涂布厚薄适宜,待自然干燥后固定,行革兰染色;用100(物镜)×10(目镜)倍显微镜观察记录。结果急性腹泻病组40例粪便涂片:革兰阴性杆菌≥50%6例(占15%);革兰阳性球菌≥50%30例(占75%);革兰阳性杆菌≥68%4例(占10%);迁延性及慢性腹泻病组62例:革兰阴性杆菌≥50%7例(占11.29%);革兰阳性球菌≥50%44例(占70.97%);革兰阳性杆菌≥68%6例(占9.68%);健康对照组32例:革兰阴性杆菌≥50%1例(占3·13%);革兰阳性球菌≥50%1例(占3·13%);革兰阳性杆菌≥68%17例(占53·13%)。3组粪便革兰阳性球菌分布比较有显著性差异(χ2=47.76P<0.05);革兰阳性杆菌分布有显著性差异(χ2=29.21P<0.01);革兰阴性杆菌分布比较无显著性差异(χ2=2.68P>0.05)。结论小儿急性、迁延性、慢性腹泻病均存在肠道菌群失调,肠道菌群失调的重要原因之一是滥用抗生素,粪便涂片检查对快速诊断菌群失调、正确治疗腹泻、避免滥用抗生素有重要意义。Objective To study the clinical significance of fecal smear examination on diagnosing intestinal flora imbalance in infantile diarrhea. Methods A sterile cotton swab was used to spread a layer of fresh feces quantum satis from a sterile container on a clean slide;the smear was fixed and stained with Gram＇s methods after it was air - dried,then the specimen was observed with a microscopy（field lens 100 × eye lens 10） and recorded. Results In the acute diarrhea group （40 cases）, the distribution feature of 3 floras on the fecal smears：≥50% Gram- negative bacilli in 6 cases （15%）,/〉50% Gram -positive cocci in 30 cases （75%） and ≥68% Gram -positive bacilli in 4 cases （ 10% ）. In the delayed and chronic diarrhea group（62 cases） ,the distribution feature of 3 floras on the fecal smears：≥50% Gram -negative bacilli in 7 cases （ 11.29% ）,≥50% Gram - positive cocci in 44 cases （70.97 % ） and ≥68% Gram - positive bacilli in 6 cases （9.68%）. In the normal control group（32 cases）, the distribution feature of 3 floras on the fecal smears：≥50% Gram -negative bacilli in 1 case（3.13% ）,≥ 50% Gram - positive cocci in 1 case（3.13% ） ,and ≥68% Gram - positive bacilli in 17 cases（53.13% ）. For the distribution of 3 floras in the 3 groups ,chi - squared test was performed, and the results showed that the difference was significant in Gram - positive cocci （X^2 = 47.76 P 〈 O. 05 ） and Gram - positive bacilli （X^2 = 29.21 P 〈 0.01 ）, but＇there was no significant difference in Gram - negative bacilli （X^2 = 2.68 P 〉0.05 ）. Conclusions Acute, delayed or chronic diarrhea can lead to flora imbalance. In order to timely and rapidly know the flora imbalance in children with diarrhea,clinically the simple,easily operated and practical smear staining method shall be widely applied.

关 键 词：腹泻 肠道菌群 菌群失调 涂片染色法 

分 类 号：R725.7[医药卫生—儿科]