【摘要】 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。更多还原

【Abstract】 Objective To investigate the diagnostic value of pathogens in lower respiratory tract infection by protected specimen brush sampling.Methods Samples were obtained by expectoration,bronchoalveolar lavage(BAL)and protected specimen brush(PSB) through fiberbronchoscopy in 78 patients who suffered from lower respiratory tract infection admitted in ICU from January 2007 to February 2008.The positive detecting rates of pathogens isolated from the samples of three samgling ways were compared.Results A total of 326 strains bacteria were obtained in 78 patients.Gram-negative bacilli were the most common(221strains,67.8%);among of them the main kinds were baumanii and Klebsiella pneumonia.Gram-positive cocci woere the second order(44strains,13.5%);among of them the staphylococcus aureus was the main kind.By the ways of PSB,BAL and expectoration,the positive rates of the pathogenic bacteria in lower respiratory tract infection were 91.0%,75.6% and 44.9% respectively and the difference was significant(P<0.05).Conclusions The positive rate of pathogenic bacteria can be enhanced by PSB,and the diagnostic specificity of pathogenic bacteria could be improved.更多还原