stooltest粪便检查英文

Stool Routine Test,Lu WanhongDepartment of NephrologyFirst affiliated hospital , Medical divisionXian Jiaotong University,Stool Analysis,What is the stool or feces?1. Waste residue of indigestible material (cellulose during the previous 4 days)2. Bile pigments and salts3. Intestinal secretions, including mucus4. Leukocytes that migrate from the bloodstream5. Epithelial cells that have been shade6. Bacteria and Inorganic material(10-20%) chiefly calcium and phosphates. Undigested and unabsorbed food.,1.Universal precaution2.Collect stool in a dry,clean container3. uncontaminated with urine or other body secretions, such as menstrual blood4.Collect the stool with a clean tongue blade or similar object.5.Deliver immediately after collection,Random Collection,Ova and parasites collection,1. Warm stools are best for detecting ova or parasites. Do not refrigerate specimen for ova or parasites.2. If the stool should be collect in 10 % formalin or PVA fixative, storage temperature is not critical.3. Because of the cyclic life cycle of parasites, three separate random stool specimens are recommended.,Enteric pathogen collection,1. Some coliform bacilli produce antibiotic substances that destroy enteric pathogen. Refrigerate specimen immediately.2.A diarrheal stool will usually give accurate results.3.A freshly passed stool is the specimen of choice.4. Stool specimen should be collected before antibiotic therapy, or as early in the course of the disease.5. If blood or mucous is present, it should be included in the specimen,Interfering factors,1. Patients receiving tetracyclines, anti-diarrheal drugs, barium, bismuth, oil, iron , or magnesium may not yield accurate results.2.Bismuth found in toilet tissue interferes with the results.3.Do not collect stool from the toilet bowl.A clean, dry bedpan is the best.4. Lifestyle, personal habbits, environments may interfere with proper sample procurement.,Normal values in stool Analysis,Macroscopic examination Normal valueAmount100-200 g / dayColourBrownOdourVaries with pH of stool and depend on bact-erial fermentationConsistencyPlastic, not unusual to see fiber, vegetable skins.Size and shape FormedGross blood,Mucous,Pus, Parasites None,Normal values in stool analysis,Microscopic examination Normal valuesFat (Colorless, neutral fat (18%)and fatty acid crystals and soaps)Undigested food None to small amountMeat fibers, Starch, Trypsin NoneEggs and segments of parasites NoneYeasts NoneLeukocytes None,Normal values in stool analysis,Chemical examinationNormal valuesWater Up to 75 %pH 6.5-7.5Occult blood NegativeUrobilinogen 50-300 g/24hrPorphyrinsCoporphyrins:400-1200g/24hr Uroporphyrins:10-40 mg/24hrNitrogen 100 ml blood) 3. Tan or Clay colored : blockage of the common bile duct.4. Pale greasy acholic (no bile secretion) stool found in pancreatic insufficiency.,4. Maroon-to-red-to-pink : possible result of bleeding from the lower gastrointestinal tract (eg. Tumors, hemorrhoids（痔）, fissures（裂）,inflammatory process)5. Blood streak（条纹） on the outer surface of usually indicates hemorrhoids or anal abnormalities.6. Blood in stool can arise from abnormalities higher in the colon. In some case the transit time is rapid blood from stomach or duodenum can appear as bright or dark red or maroon in stool.,Stool color (contd),Blood in Stool,Normal value: NegativeClinical Implication :1. Dark red to tarry black indicates a loss of blood from the upper GI tract. 2. Positive for occult blood may be caused bya. Carcinoma of colonb. Ulcerative colitisc. Adenoma d. Diaphramatic herniae. Gastric carcinomaf. Diverticulitis憩室炎 g. Ulcers,Mucous in Stool,Normal value: Negative for mucousClinical Implication:1. Translucent （半透明） gelatinous （凝胶状） mucous clinging to the surface of formed stool occurs in a. Spastic constipation b. Mucous colitis c. Emotionally disturbed patients d. Excessive straining at stool2. Bloody mucous clinging to the surface suggests a. Neoplasm b. Inflammation of the rectal canal,Mucous in Stool (contd),3. Mucous with pus and blood is associated witha. Ulcerative colitisb. Bacilliary dysentery（杆菌痢疾 ）c. Ulcerating cancer of colond. Acute diverticulitis（憩室炎 ）e. Intestinal tuberculosis,Fat in Stool,Normal value: fat in stool will account for up to 20 % of total solids. Lipids are measured as fatty acids (0-6.0 g/24hr) Clinical Implication:1. Increased fat or fatty acids is associated with the malabsorption syndromes a. Nontropical sprue（celiac sprue ）b. Crohns disease c. Whipples diseased. Cystic fibrosise. Enteritis and pancreatic diseasesf. Surgical removal of a section of the intestine,Urobilinogen in Stool,Normal value:125-400 Ehrlich units / 24 hr 75-350 Ehrlich units/100 g Clinical Implication:Increased values are associated with Hemolytic anemiasDecreased values are associated with a. Complete biliary obstructionb. Severe liver disease, infectious hepatitisc. Oral antibiotic therapy that alters intestinal bacteria florad. Infants are negative up to 6 months of age,Bile in Stool,Normal value: Adults negative: Children may be positiveClinical Implication:1. Bile may be present in diarrheal stools.2. Increased bile levels occur in Hemolytic anemia,Trypsin in Stool（胰蛋白酶）,Normal value: （胰蛋白酶）Positive in small amounts in 95 % of normal persons.Clinical Implication: Decreased amounts occur in- Pancreatic deficiencyMalabsorption syndromesScreen for cystic fibrosis,Leukocytes in Stool,Normal value: Negative Clinical Implication1. Large amounts of leukocytesa. Chronic ulcerative colitis b. Chronic bacilliary dysenteryc. Localized abscessd. Fistulas of sigmoid rectum or anus2. Mononuclear leukocytes appear in Typhoid,Leukocytes in Stool (contd),3. Polymorphonuclear leukocytes appear ina. Shigellosisb. Salmonellosisc. Yersiniad. Invasive Escherichia coli diarrheae. Ulcerative colitis4. Absence of leukocytes is associated witha. Cholerab. Non specific diarrhea c. Viral diarrhead. Amebic colitise. Noninvasive E.coli diarrhea f. Toxigenic bacteria Staphylococci spp., Clostidium Cholera g. Parasites-Giardia,Porphyrins in Stool（卟啉类化合物