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目的了解经纤支镜防污染毛刷对下呼吸道感染的病原学诊断的价值,以指导临床用药。方法对2007年1月至2008年2月ICU病房78例下呼吸道感染患者分别经咳痰、支气管肺泡灌洗(BAL)及纤支镜防污染毛刷(PSB)3种方式取样,根据培养结果分析病原菌的构成,比较3种方法在下呼吸道感染病原学诊断中的应用价值。结果78例患者共分离出菌株326株,培养结果以革兰阴性杆菌占首位(221株,67.8%),以不动杆菌、肺炎克雷伯菌为主;革兰阳性球菌占第2位(44株,13.5%),以金黄色葡萄球菌为主。不同方法采样培养致病菌分离的阳性率,PSB法为91.0%,BAL法为75.6%,痰检法为44.9%,三者比较,差异有统计学意义(P<0.05)。结论PSB法能提高致病菌的阳性分离率,有良好的防污染作用,可以提高下呼吸道感染病原学诊断的特异性。
Objective To understand the value of bronchoscopy anti-pollution brush on the etiological diagnosis of lower respiratory tract infection in order to guide clinical medication. Methods From January 2007 to February 2008, 78 patients with lower respiratory tract infection in ICU ward were sampled by means of sputum aspiration, bronchoalveolar lavage (BAL) and defibrillator (CTB) with bronchofiberscopy, respectively. According to the results of culture Analysis of the composition of pathogens, the comparison of three methods in the diagnosis of lower respiratory tract infection in the application of value. Results A total of 326 strains were isolated from 78 patients. Gram-negative bacilli accounted for the first place (221 strains, 67.8%), mainly Acinetobacter and Klebsiella pneumoniae; Gram-positive cocci accounted for the second place 44 strains, 13.5%), mainly Staphylococcus aureus. The positive rate of pathogenic bacteria isolated by different methods was 91.0% by PSB method, 75.6% by BAL method and 44.9% by sputum method. The difference was statistically significant (P <0.05). Conclusion The PSB method can improve the positive isolation rate of pathogens, and has a good anti-pollution effect, which can improve the specificity of etiological diagnosis of lower respiratory tract infection.