颅脑手术后气管切开伴肺部感染患者取痰方法的研究

Study of obtaining sputum specimens in lung infection patients with tracheotomy after brain surgery

目的探讨颅脑手术后气管切开伴肺部感染患者常规取痰法、随机取痰法和经纤维支气管镜深部取痰法的优劣。方法采用常规取痰方法、随机取痰方法和经纤维支气管镜深部取痰法对64例颅脑术后气管切开肺部感染患者进行取痰,并对细菌培养结果进行比较。结果本组痰培养阳性43例(53.13%)。其中常规取痰阳性24例(37.5%),随机取痰阳性32例(50.0%),经纤维支气管镜深部取痰阳性42例(65.63%)。经纤维支气管镜深部取痰法阳性率显著高于常规取痰法及随机取痰法(均P<0.05)。常规取痰法与随机取痰法阳性率差异无统计学意义(P>0.05)。经纤维支气管镜深部取痰法G-杆菌、肺炎克雷伯杆菌、大肠埃希菌及真菌阳性率显著高于常规取痰法及随机取痰法(均P<0.05),常规取痰法及随机取痰法以上差异均无统计学意义。3种方法的G+杆菌阳性率差异无统计学意义(均P>0.05)。结论颅脑手术后气管切开伴肺部感染患者支气管镜深部吸痰方法优于常规取痰法和随机取痰法。

Objective To explore the advantages and disadvantages of fiberoptic bronchoscopy obtain deep sputum method,conventional obtain sputum method and randomly obtain sputum method in lung infection patients with tracheotomy after brain surgery. Methods The sputum samples of lung infection patients with tracheotomy after brain surgery were retained by fiberoptic bronchoscopy obtain deep sputum method,conventional obtain sputum method and randomly obtain sputum method. The results of bacterial culture were compared. Results Fourty-three cases（ 53. 13%） were positive for sputum culture. Twenty-four cases（ 37. 5%） were positive for sputum culture by conventional obtain sputum method; 32 cases（ 50. 0%） were positive for sputum culture by randomly obtain sputum method; and 42 cases（ 63. 63%） were positive for sputum culture by fiberoptic bronchoscopy obtain deep sputum method. The positive rate of sputum culture by fiberoptic bronchoscopy obtain deep sputum method was significantly higher than that in conventional method and randomly obtain sputum method（ all P〈0. 05）,and there was no statistical significance between conventional method and randomly obtain sputum method（ P〈0. 05）. The positive rates of G-bacilli,klebsiella pneumoniae,escherichia coli and fungal by fiberoptic bronchoscopy obtain deep sputum method were significantly higher than those in conventional method and randomly obtain sputum method（ all P〈0. 05）,and there was no statistical significance between conventional method and randomly obtain sputum method.The positive rates of G＋bacilli had no statistical significance between the 3 methods（ all P〈0. 05）. Conclusion The fiberoptic bronchoscopy obtain deep sputum method is better than conventional obtain sputum method and randomly obtain sputum method in lung infection patients with tracheotomy after brain surgery.