检查人螨形螨的技术方法(中英文)

来源:中州制药      发布时间:2012-05-09       阅读次数:
检查人蠕形螨的技术和方法
      (一)、设备:1,医学生物显微镜一台。(有带显像转换器CCD和显示屏设备的更好)。A,显微镜要求:最好是双目,双光源(电光源,自然光源)。B,有机械式移动性载物台。C,接目镜头16倍或10倍。接物镜头低10倍,高40倍即可。2,皮脂溶解剂:清澈的植物油。(豆油、菜子油,芝麻油,市场卖的色拉油均可。不能用石腊油,甘油,香波油,生理盐水等)。3装油小瓶和滴管。4、拇指和食指乳胶指套。5、脱脂棉球。6、载玻片。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),或暗疮针。8、消毒液3%--5%来苏尔LIOUOR CRESLI SAPONATUS(甲酚皂)溶液。取螨器和所用过玻片消毒用。
      (二)、检螨取样,取皮脂的方法:人蠕形螨最适合生长繁殖的部位即人面部皮肤毛嚢皮脂腺内。所以要取皮脂才能查出螨虫。其方法:先将右手拇指、食指戴上指套,再将玻片上滴上三点三滴油备用。医师与患者面对面坐下,医师用戴上指套的右手拇指和食指运用合力挤压患者的鼻沟部和鼻尖部。挤压出白色豆乳状皮脂后用取螨器刮下皮脂放入玻片中间油滴内并溶解均匀。再用左手拇指将患者额部皮肤向上推,让患者眼睛向下看,同时用右手持取螨器用尖侧背向内向下挤压刮出皮脂放入载玻片另一个油滴内溶解。后让患者口咬着下嘴唇,医师用右手持取螨器在下额部皮肤上向下刮挤压出皮脂放入载玻片第三滴油内溶解。(用暗疮针同样方法)将取螨器放入来苏尔消毒液内消毒以备再用。取下指套,将玻片放在显微镜载物台上,先对准底倍镜头下,先用底倍镜观察,调好焦距和光度,以看清油中的皮脂和物体。像拉网式的在油滴中寻找螨虫形态,包括成螨,(活动的、死亡的残体)、虫卵、幼虫、若虫,再分长形螨、短形螨。凡是检出的上述各种形态的螨均应计数为患者螨的感染度。如分不清时可转换用高倍镜头细辩。如果第一次取脂检查不出螨虫的可再反复一次再查。附:人蠕形螨各期形态图。一位熟练的医师一般情况下5—10分钟即可完成一个患者的检螨诊断。注意:成螨在离开人体放在植物油内长短螨均可活动。温度在25—36摄氏度情况下有的可存活36—58小时,它活动最活跃的温度28—33摄氏度。活螨在25摄氏度以下的温度一般则停止活动。所以在冬季室内温度底于25度以下时,要想看到成螨的活动必须将溶解皮脂的玻片放在手心里暖2—3分种立即放在显微镜下观察才能看到成螨的活动。卵、幼虫、若虫、死螨是不会活动的。若进行医学研究,医师可将取出的皮脂先放入皮脂定量凹糟内打平定量,再用取螨器尖部将糟内皮脂取出放在载玻片油滴内溶均后再放到显微镜下仔细观察螨的数量计数。以备与下一次在同部位检螨计数相对照。
      上述方法挤脂时有的患者感到不适有重压感或疼痛,但这种检螨方法比较准确可靠,并能一目了然看到螨虫活动。而过去使用1   公分平方透明胶布贴在患者鼻翼处,前晚贴上第二天早上取下再放在玻片上在显微镜检螨的方法,虽然患者无上述痛感,但是既浪费时间、又不准确,有时患者睡觉会磨擦掉,不得不重复再作。这种检测方法只能看到死的成虫,而看不到卵、幼虫、若虫又看不到活动的成螨。不能作科学研究计数。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