纤维支气管镜对老年难治性肺炎原因及病原学诊断意义

Significance of fibreoptic bronchoscopy for causes and etiological diagnosis of elderly patients with refractory pneumonia

目的探讨针对难治性老年肺炎患者实施经纤维支气管镜检查,对发病原因以及病原学分布诊断的临床意义。方法难治性老年肺炎患者80例,实施纤维支气管镜检查,于病变处实施支气管肺泡灌洗,此后进行病原学辅助检查,比较患者病原学阳性率与入院时常规痰培养病原学阳性率。结果出现42例单纯性炎症性改变;病原菌对于喹诺酮类等抗菌物耐药率较高,耐药率较低是亚胺培南等。患者入院时痰培养与BALF一致12例。结论纤维支气管镜检查可以提升病原学诊断,提升治疗有效性。

Objective To explore the clinical significance of fibreoptic bronchoscopy for causes and etiologi- cal diagnosis of elderly patients with refractory pneumonia. Methods 80 elderly patients with refractory pneumonia were given fibreoptic bronchoscopy. And then they were given accessory examination. The etiological positive rate of sputum culture was observed. Results There were 42 cases of simple inflammatory changes. Pathogens showed a high resistance to fluoroquinolones and other antimicrobial drugs and low resistance to imipenem. The results of spu- tum culture were consistent with BALF in 12 cases. Conclusion Bronchoseopes can enhance the etiological diagno- sis and guide the use of antibiotics to enhance treatment effectiveness.