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目的:探讨纤维支气管镜在小儿细菌性肺炎病原学检查中的意义。方法:对116例细菌性支气管肺炎患儿应用小儿纤维支气管镜抽取右主支气管开口处痰液做痰培养同时做血培养,并做药物敏感试验,进行比较和分析。结果:应用小儿纤维支气管镜取痰标本做培养阳性82例,阳性率70.7/,远高于血培养的26.7/。82例纤维支气管镜取痰标本共培养出病原菌122株,革兰阴性(G-)杆菌在我院儿科细菌性支气管肺炎致病菌的比例较高,达63.9/,超过革兰阳性(G+)球菌的30.3/。药敏测试结果显示,G+球菌对头孢噻吩、奈替米星、红霉素、环丙沙星耐药率已超过80/,而普遍对万古霉素敏感;G-杆菌对泰能均敏感,对环丙沙星、妥布霉素、左氧氟沙星等药比较敏感,对头孢类抗生素耐药率较高。结论:应用小儿纤维支气管镜取痰标本做培养能较好地检出小儿细菌性肺炎的致病菌,是可靠而切实可行的方法。
Objective: To explore the significance of bronchoscopy in the etiological examination of bacterial pneumonia in children. Methods: 116 cases of children with bacterial bronchial pneumonia were treated with pediatric bronchofibroscopy at the opening of the right main bronchial sputum sputum culture at the same time to do blood culture, and drug sensitivity test, comparison and analysis. Results: There were 82 positive cases in sputum samples collected from children with bronchoscopy, the positive rate was 70.7%, much higher than that of 26.7% in blood culture. A total of 122 pathogenic bacteria were co-cultured with sputum from 82 cases of bronchofibroscopy. The proportion of Gram-negative bacilli in pediatric patients with bacterial bronchopneumonia was 63.9%, higher than Gram-positive (G +), Cocci 30.3 /. Drug susceptibility test results showed that the antibacterial rate of cefalotin, netilmicin, erythromycin and ciprofloxacin of G + cocci was more than 80%, which was generally sensitive to vancomycin. G- Ciprofloxacin, tobramycin, levofloxacin and other drugs more sensitive to higher rates of resistance to cephalosporins. Conclusion: It is a reliable and practical method to detect the pathogen of bacterial pneumonia in children by using the bronchofibroscope to take sputum samples for culturing.