2008-2023 年杭州市结核病实验室痰涂片室间质控结果分析  

Interventricular quality control results of sputum smears intuberculosis laboratories in Hangzhou City,2008-2023

作　　者：吴亦斐 贾庆军 黄银燕 程庆林[1] 白雪欣 李清春[1] WU Yifei;JIA Qingjun;HUANG Yinyan;CHENG Qinglin;BAI Xuexin;LI Qingchun(Institute of Tuberculosis Control,Hangzhou Municipal Center for Disease Control and Prevention(Hangzhou Municipal Institute of Health Supervision),Hangzhou,Zhejiang 310021,China)

机构地区：[1]杭州市疾病预防控制中心(杭州市卫生监督所)结核病防治所,浙江杭州310021

出　　处：《实用预防医学》2025年第3期373-377,共5页Practical Preventive Medicine

基　　金：浙江省基础公益研究计划项目(LGF21H190002);浙江省医药卫生科技计划项目(2020KY238);浙江省医药卫生科技计划项目(2021KY951);杭州市医药卫生科技计划一般项目(A20200280);杭州市医药卫生科技计划一般项目(A20200788)。

摘　　要：目的分析杭州市结核病定点医疗机构实验室痰涂片盲法复检工作的质量,以提高该地结核病痰检工作质量和防控效果。方法按照《中国结核病防治规划痰涂片镜检标准化操作及质量保证手册》,对杭州市辖区内的结核病定点医院实验室进行痰涂片盲法复检。结果2008—2023年对杭州各区县(市)定点医院进行盲法复检,共抽检痰涂片12858张,阳性片1573张(12.2%),平均符合率为98.9%;阴性片11285张(87.8%),平均符合率为98.9%;总符合率为98.9%。各年的阴性符合率、总体符合率和痰细胞、痰膜大小、厚薄、染色等痰涂片制片质量观察指标差异有统计学意义,呈上升趋势(χ^(2)_(趋势)=7.139、χ^(2)_(趋势)=9.404、χ^(2)_(趋势)=180.387、χ^(2)_(趋势)=4.238、χ^(2)_(趋势)=144.489、χ^(2)_(趋势)=27.096,P<0.05),各区(县市)的阴性涂片符合率和总体符合率的差异有统计学意义(χ^(2)=18.767、χ^(2)=17.647,P<0.05)。结论杭州市各级结核病实验室痰涂片镜检工作质量总体良好,但仍需加强对各级定点医疗机构实验室的室间质控工作,发挥人才优势,提高痰检能力,更好地为杭州市的结核病防治体系提供技术保障。Objective To analyze the quality of blinded rechecking of sputum smears in the laboratories of designated medicalinstitutions for tuberculosis in Hangzhou City so as to improve the quality of sputum smear examination and the control effect oftuberculosis.Methods According to the requirements of the Quality Assurance Manual for Sputum Smears in China’sTuberculosis Control Program,and sputum smears were collected from the laboratories of tuberculosis-designated hospitals inHangzhou City for blinded rechecking.Results A total of 12,858 sputum smears were sampled from designated hospitals ineach districts,counties(cities)in Hangzhou during 2008-2023,and the sputum smears were blindedly rechecked.There were1,573(12.2%)positive smears and 11,285(87.8%)negative smears detected,the average coincidence rate was 98.9%,and thetotal coincidence rate 98.9%.There were statistically significant differences in the negative coincidence rate,the total coincidencerate and the sputum smear quality observation indexes like sputum cells,sputum film size,smear thickness and staining in eachyear,showing upward trends(χ^(2)_(trend)=7.139,χ^(2)_(trend)=9.404,χ^(2)_(trend)=180.387,χ^(2)_(trend)=4.238,χ^(2)_(trend)=144.489,χ^(2)_(trend)=27.096,P<0.05).The differences in the negative smear coincidence rates and the total coincidence rates in each district(county and city)were statistically significant(χ^(2)=18.767,χ^(2)=17.647,P<0.05).Conclusion The quality of sputum smear examination in thelaboratories at all levels in Hangzhou City was generally good.But it is still necessary to strengthen the interventricular qualitycontrol of sputum smear examination in the laboratories of designated medical institutions at all levels,give full play to theadvantages of talents,and improve the ability in sputum detection so as to better provide technical support for the tuberculosisprevention and control system in Hangzhou City.

关 键 词：结核病 痰涂片 质量控制 盲法复检 

分 类 号：R378.91[医药卫生—病原生物学]