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檢查人螨形螨的技術(shù)方法(中英文)

來(lái)源:中州制藥      發(fā)布時(shí)間:2012-05-09       閱讀次數:
檢查人蠕形螨的技術(shù)和方法
      (一)、設備:1,醫學(xué)生物顯微鏡一臺。(有帶顯像轉換器CCD和顯示屏設備的更好)。A,顯微鏡要求:最好是雙目,雙光源(電光源,自然光源)。B,有機械式移動(dòng)性載物臺。C,接目鏡頭16倍或10倍。接物鏡頭低10倍,高40倍即可。2,皮脂溶解劑:清澈的植物油。(豆油、菜子油,芝麻油,市場(chǎng)賣(mài)的色拉油均可。不能用石臘油,甘油,香波油,生理鹽水等)。3裝油小瓶和滴管。4、拇指和食指乳膠指套。5、脫脂棉球。6、載玻片。7、取螨器。皮脂定量器科研用(特制即制有0.5立方毫米凹糟),或暗瘡針。8、消毒液3%--5%來(lái)蘇爾LIOUOR CRESLI SAPONATUS(甲酚皂)溶液。取螨器和所用過(guò)玻片消毒用。
      (二)、檢螨取樣,取皮脂的方法:人蠕形螨最適合生長(cháng)繁殖的部位即人面部皮膚毛嚢皮脂腺內。所以要取皮脂才能查出螨蟲(chóng)。其方法:先將右手拇指、食指戴上指套,再將玻片上滴上三點(diǎn)三滴油備用。醫師與患者面對面坐下,醫師用戴上指套的右手拇指和食指運用合力擠壓患者的鼻溝部和鼻尖部。擠壓出白色豆乳狀皮脂后用取螨器刮下皮脂放入玻片中間油滴內并溶解均勻。再用左手拇指將患者額部皮膚向上推,讓患者眼睛向下看,同時(shí)用右手持取螨器用尖側背向內向下擠壓刮出皮脂放入載玻片另一個(gè)油滴內溶解。后讓患者口咬著(zhù)下嘴唇,醫師用右手持取螨器在下額部皮膚上向下刮擠壓出皮脂放入載玻片第三滴油內溶解。(用暗瘡針同樣方法)將取螨器放入來(lái)蘇爾消毒液內消毒以備再用。取下指套,將玻片放在顯微鏡載物臺上,先對準底倍鏡頭下,先用底倍鏡觀(guān)察,調好焦距和光度,以看清油中的皮脂和物體。像拉網(wǎng)式的在油滴中尋找螨蟲(chóng)形態(tài),包括成螨,(活動(dòng)的、死亡的殘體)、蟲(chóng)卵、幼蟲(chóng)、若蟲(chóng),再分長(cháng)形螨、短形螨。凡是檢出的上述各種形態(tài)的螨均應計數為患者螨的感染度。如分不清時(shí)可轉換用高倍鏡頭細辯。如果第一次取脂檢查不出螨蟲(chóng)的可再反復一次再查。附:人蠕形螨各期形態(tài)圖。一位熟練的醫師一般情況下5—10分鐘即可完成一個(gè)患者的檢螨診斷。注意:成螨在離開(kāi)人體放在植物油內長(cháng)短螨均可活動(dòng)。溫度在25—36攝氏度情況下有的可存活36—58小時(shí),它活動(dòng)最活躍的溫度28—33攝氏度?;铗?5攝氏度以下的溫度一般則停止活動(dòng)。所以在冬季室內溫度底于25度以下時(shí),要想看到成螨的活動(dòng)必須將溶解皮脂的玻片放在手心里暖2—3分種立即放在顯微鏡下觀(guān)察才能看到成螨的活動(dòng)。卵、幼蟲(chóng)、若蟲(chóng)、死螨是不會(huì )活動(dòng)的。若進(jìn)行醫學(xué)研究,醫師可將取出的皮脂先放入皮脂定量凹糟內打平定量,再用取螨器尖部將糟內皮脂取出放在載玻片油滴內溶均后再放到顯微鏡下仔細觀(guān)察螨的數量計數。以備與下一次在同部位檢螨計數相對照。
      上述方法擠脂時(shí)有的患者感到不適有重壓感或疼痛,但這種檢螨方法比較準確可靠,并能一目了然看到螨蟲(chóng)活動(dòng)。而過(guò)去使用1   公分平方透明膠布貼在患者鼻翼處,前晚貼上第二天早上取下再放在玻片上在顯微鏡檢螨的方法,雖然患者無(wú)上述痛感,但是既浪費時(shí)間、又不準確,有時(shí)患者睡覺(jué)會(huì )磨擦掉,不得不重復再作。這種檢測方法只能看到死的成蟲(chóng),而看不到卵、幼蟲(chóng)、若蟲(chóng)又看不到活動(dòng)的成螨。不能作科學(xué)研究計數。此法早已淘汰不用。
 
   The technique And method for inspecting
 Human larva form acarid (Demodex)
 
      (1),Equipmen:
 
1,A medical biomicroscope (with vision transformer CCD and display screen the better)
      Requirement for microscope:
A, binoculars, double light sources (electric or nature light) the better,
B, Designed with a mechanical mobile platform,
C, Eue len 16x Objeet: low10x, high40x
      2, Sebaceous dissolvent: limpid vegetable oil (bean oil,rape-seed oil,sesame oil and salad oil bought from market are all valid, don’tuse liquid paraffin, glycerin, shampoo oil, normal saline, etc,)
      3, Little bottle for holding oil and a pipette,
      4, Latex glove for thumb and second finger,
      5, Absorbent cotton ball,
      6, Loading glass,
      7,Taking mite apparatus, sebaceous quantitative apparatus (designedparticularly and pattern enclosed)  acne needle,
      8, Sterile solution:3%--5%liquor cresolis saponatus (Lysol)
      (2), Get specimen for inspecting Demodex
      The method for getting sebaceous:The sebaceous gland of skin hair follicle of human face is the best place for the growth and breed of human larva form acarid, So we have to get sebaceous first, if we want toinspect the Demodex
      Method: First, let your thumb and second finger wear latex glove, then, drop three guttae vegetable oil on the glass respectively, The doctor and patient sit down face to face, the doctor, using right hand thumb and second finger worn glove, squeeze the nose top and nose sulcus of the patient, when the sebaceous had squeezed out, you can get the sebaceous off with the taking mite apparatus, and put it in the oil gutta, which is on the glass center, and dissolve it Then, using your left thumb, push the patient`s frontal skin up, meanwhile let the patient look down, then, with your right hand hold the taking mite apparatus, its point side back to inside and face down, shave the sebaceous off,and put it in the other oil gutta on the loading glass, dissolve it, then, let patient gnash his lower lip, With right hand, you can hold taking mite appartus, to shave the patien’s submandibularis skin, from outside to inside and downwards, when you get the sebaceous, put it in the third oil gutta on theloading glass, dissolve it Or,you can also use the round head part of the acne needle to press and shave the place described above, to get the sebaceous and put it in the oil gutta, and dissolve it then, put the taking mite apparatus in Lsol to sterilize it, prepared for use Get off the glove, put the loading glass on the platform of the microscope examining it with low power first, modify the focus and light,as tosee, the mite and masses in oil clwarly, to find mite in oil guttae, include living and dead adult worm, immobile worm eggs, nymph and remain bodies, by draw net style , and differentiate long form mite from short form mite , All the mites showed the form described above being inspeeted should count as infectton level, if not clearly. You may transfer to high power microscope, If you can ‘t find out the mtie in sebaceous that you had gotten at first time (naybe the method you used qas not propetly )you can get the sebaceous again with the same method to examine.
      Enclose:The morphology for all period of human larva form acarid,
      An experienced doctor may complete an inspecting mite diagnosis in 5—10minutes in common.
      Notice: When adult mite get off from human body, and was put in vegetable oil, the long and short fofm mite both can nove about , in temperature 25—36℃,some can live 36—58 hours, its most dynamic temperature is 28℃--33℃.Under 25℃,living mite will stop its motion, So,in winter, when room trmperature under 25℃,you have to hold the glass, which loading the dissolved sebaceous , in palm to worm it for three minutes, examining it under microscope at once. till then,you can see the adult mite motion, Worm eggs, larvae, nymph and dead mite can not move , If you observe nymph under high power microscope carefully, you may see its mouth moving  
     If you want to do medical research, you may put the gotten sebaceous in the sunken groove (0.5mm)of the sebaceous quantitative apparatus, press it even, then take off thes certain volume sebaceous by the point taking mite apparatus, and put it in the oil gutta on the loading glass, dissolve it, then observe it under the microscope carefully, count the number of the mites, write down the lomg and short form mites number respectinely and the palce they are from, include worm eggs, larvae and remain bodies, as to compare with the number inspected in same place the next time.
     With the method described above, when squeezing sebaceous, some patients feel uncomfortable, and you may see through the movement of the mites, the oid method, patch a 1cm transparent adhesive tape on the patient’s nose alar last night , and take it off in the morning the second day, and put it on the glass, then, observe it undeeer microscope, Although, with this method, patient have not any pain described above, but was time –consuming and was not accurate , Sonmetimes, patient will scrub the tape off in sleeping , So,you hane to do it again , By this method , you can see the dead adult mites only, Generally, you can’t see the worm egg, larva or nymph , you can’t do science count also, The oid method hhad been ahandoned long ago.
    Chinese specialist of preventing and treating human larva form acaridiasis:ZhaoZhong-zhou
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