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目的探讨纤维支气管镜检查对老年难治性肺炎患者病原学诊断的意义。方法 100例难治性的老年肺炎患者,均行纤维支气管镜检查,并在病变处行支气管肺泡灌洗及病原学检查,与常规痰培养检查的病原学检出率比较并进行药敏检查。结果常规痰培养检查与肺泡灌洗液培养检查病原菌一致的有16例;第三代头孢菌素、喹诺酮类、氨基糖苷类的耐药率比较高,耐药率较低为头孢哌酮/舒巴坦、亚胺培南。结论对于难治性肺炎患者,尤其是老年患者,早期行纤维支气管镜检查能够提高病原学的检出率,对抗生素的应用指导作用也更加明确。
Objective To investigate the significance of fibrobronchoscopy in the etiological diagnosis of elderly patients with refractory pneumonia. Methods 100 cases of elderly patients with refractory pneumonia were examined by fiberoptic bronchoscopy. Bronchoalveolar lavage and etiological examination were performed on the lesions. The detection rate of etiology was compared with that of routine sputum culture and susceptibility testing was performed. Results Conventional sputum culture examination and bronchoalveolar lavage fluid culture pathogen identification consistent with 16 cases; third-generation cephalosporins, quinolones, aminoglycoside resistance rate is relatively high, the lower rate of resistance to cefoperazone / Batan, imipenem. Conclusions For patients with refractory pneumonia, especially in elderly patients, early detection of fibrobronchoscopy can increase the detection rate of the etiology, the guiding role of antibiotics is also more clear.