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目的 :研究防污染标本刷 (PSB)采样法在院内感染性肺炎 (NP)病原学诊断中的作用。方法 :选择气管切开 (或插管 )的患者 10 8例 ,发生NP的为病例组 ( 50例 ) ,未发生NP的为对照组 ( 58例 ) ,所有病例分别用PSB法、吸痰法和常规咽拭子法作细菌定量培养 ,比较各种采样法的敏感性和特异性。结果 :PSB法和吸痰法所分离到的细菌类型基本一致 ,有 5例患者同时分离到 2种致病菌。PSB法和吸痰法的敏感性分别为 92 %与 84 % ;特异性分别为 96.6%与 93.1% ,均显著优于咽拭子法的敏感性及特异性 ( 4 2 % ,2 9.3% ) ,前者 χ2 =19.62 ,P <0 .0 1,后者 χ2 =17.16,P <0 .0 1。PSB法的敏感性和特异性虽然略高于吸痰法 ,但无显著性差异 ,χ2 =1.17,P>0 .0 5。然而吸痰法操作复杂 ,标本处理繁琐 ,污染环节多。结论 :PSB采样法是目前NP病原学诊断上敏感性和特异性均较高的采样技术 ,且操作安全简便 ,值得在临床推广应用
Objective: To study the role of anti-pollution specimen brush (PSB) sampling in the etiological diagnosis of nosocomial pneumonia (NP). Methods: A total of 108 patients with tracheotomy (or intubation) were enrolled in this study. The incidence of NP was 50 cases in the NP group and 58 cases in the NP group. All cases were treated with PSB, And routine throat swab method for bacterial quantitative culture, comparing the sensitivity and specificity of various sampling methods. Results: The types of bacteria isolated by PSB and sputum aspiration were basically the same, and 5 kinds of patients were also isolated 2 kinds of pathogenic bacteria. The sensitivities of PSB and sputum aspiration were 92% and 84% respectively, and the specificity were 96.6% and 93.1% respectively, which were significantly better than those of throat swab (42% and 293%, respectively) , The former χ2 = 19.62, P <0. 01, the latter χ2 = 17.16, P <0. Although the sensitivity and specificity of PSB method were slightly higher than that of suction method, there was no significant difference (χ2 = 1.17, P> 0.05). However, suction method of complex operation, cumbersome specimen handling, pollution and more links. Conclusion: PSB sampling method is the sampling technique with high sensitivity and specificity in NP etiological diagnosis at present, and it is safe and easy to operate and worthy of clinical application