本文目录一览:
- 1、怎样做结核菌素试验?
- 2、简述结核菌素试验的原理,结果判断及意义?
- 3、结核菌素试验
怎样做结核菌素试验?
做结核菌素试验多采用“人型结核菌素纯蛋白衍化物(PPD)”进行试验,故称做PPD试验。
具体的做法是在小孩子的前臂掌侧中部,进行皮内注射PPD,就像做青霉素皮试那样,所不相同之处是观察结果的时间不同,在注射PPD48~72小时后,再检查注射部位的反应。
如果注射部位只有针眼大小的痕迹,而无硬结,则为阴性反应,此时应请医生做进一步检查,以探明其原因,是否与小孩子机体本身免疫功能不足有关,还是与卡介苗接种过程技术操作有关,然后再做处理。
如果注射部位出现红肿并有直径约5~10毫米大小的硬结,则呈阳性反应,大约95%以上的小孩子为阳性反应,这说明卡介苗接种后已产生了对抗结核病的免疫力。如果注射部位的硬结超过20毫米,或在红肿、硬结上出现水泡、坏死或有淋巴管炎,均属于强阳性反应,这时应到医院进一步检查,以确定结核感染的情况,做出相应的处理。
当你的孩子患有急性传染病,如麻疹、百日咳、流感、肺炎、急性眼结膜炎、急性中耳炎、广泛性皮肤病及有过敏史者均不要做PPD试验。
简述结核菌素试验的原理,结果判断及意义?
原理:
结核菌素皮肤反应是迟发型细胞超敏反应。它是抗原(结核菌或卡介苗)进入机体使机体的免疫T淋巴细胞致敏,并大量分化增殖。
当已致敏的机体再次遭受到抗原入侵时,致敏淋巴细胞就会与之结合,引起变态反应性炎症。表现在结核菌素注射部位形成硬结甚至发生水泡、坏死。
结素试验阳性表明机体曾经受到结核菌感染或接种过卡介苗,也表示机体对结核菌有一定免疫力。但也有少数免疫力低下的人(约5%)呈阴性或因技术原因而呈现假阴性。通常接种卡介苗后,若PPD皮试阴性,说明接种失败。
结核的免疫特点为“免疫、感染、超敏反应”共存。
判断:
通常在前臂掌侧皮内注射5IU的PPD,经48-72小时检查局部反应,凡硬结直径平均〉5㎜为阳性;6-10㎜为+;11-20㎜为++;>20㎜为+++;局部发生水泡为++++。
意义:
(一)阴性反应
未受结核杆菌感染,或免疫反应窗口期。
(二)阳性反应
说明已受结核杆菌感染,可能有以下几种情况:
1、结核病患者,但不能作为确诊依据;
2、卡介苗接种后,免疫反应已建立;
3、3岁以内未种卡介苗者,提示体内存在结核病灶;
4、非结核分枝杆菌交叉反应。
(三)强阳性反应
1、有助于确诊结核病;
2、已感染,未发病者;
3、强阳性人群结核病发病率高,在未找到病变时,可以实施预防性治疗;
4、强阳性伴有肺部病灶时,则有利于结核病的诊断。但肺部无病灶时,说明机体处于结核菌敏感状态。
扩展资料:
结核菌素接种部位:
左前臂掌侧中部、皮肤无疤痕的部位。
结核菌素试验的禁忌:
患急性传染病(如麻疹、百日咳、流行性感冒、肺炎等);急性眼结合膜炎、急性中耳炎、广泛皮肤病者及过敏体质者;血液病;发热。
参考资料:百度百科-结核菌素试验
结核菌素试验
结核菌素试验的结果分析:0--0.5cm,为阴性;0.5--0.9cm为阳性,0.9--1.5cm为强阳性。假阴性也是有可能的,例如免疫缺陷,当然结果要在48--72小时之后才能看出来。
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