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目的探讨3种不同的采样方法在医院获得性肺炎(HAP)病原学诊断中的价值,以选择更准确、便捷、经济的病原菌标本采用方法。方法 85例HAP患者分别留取常规咳痰法、经纤维支气管镜防污染毛刷(PSB)和支气管肺泡灌洗(BAL)采样标本,进行培养、分离和鉴定。结果经常规咳痰法、BAL和PSB 3种采样方法病原菌培养阳性率分别为54.1%、83.5%和95.3%,差异有统计学意义(P<0.05);3种采样方法检测出病原菌均以革兰阴性菌为主,分别占82.6%、81.7%和79.0%;分布最多的病原菌为肺炎克雷伯菌、铜绿假单胞菌和金黄色葡萄球菌。结论经PSB临床培养阳性率高,对HAP病原菌诊断具有较高特异性。
Objective To explore the value of three different sampling methods in the etiological diagnosis of hospital-acquired pneumonia (HAP) in order to select a more accurate, convenient and economical method for the use of pathogenic bacteria specimens. Methods Totally 85 HAP patients were enrolled in this study. They were routinely sputum smear, PSB and BAL samples were collected for culture, isolation and identification. Results The results showed that the positive rates of pathogenic bacteria culture by conventional sputum method, BAL and PSB were 54.1%, 83.5% and 95.3%, respectively, with statistical significance (P <0.05). The pathogenic bacteria were all detected by three sampling methods The main pathogens were Klebsiella pneumoniae, Pseudomonas aeruginosa and Staphylococcus aureus, accounting for 82.6%, 81.7% and 79.0% respectively. Conclusion The positive rate of clinical culture by PSB is high, and it has high specificity for the diagnosis of HAP pathogens.