探讨气管镜在重症肺炎病原学诊断中的作用

Exploration on the etiologic diagnostic value of bronchoscope for the severe lung infection

目的评估经气管镜进行直接吸引、支气管肺泡灌洗及保护性毛刷刷检3种病原学取样方法的优点和缺点。方法对72例重症肺炎合并呼吸衰竭住院患者进行直接吸痰、管吸痰及经气管镜直接吸引、保护性毛刷刷检、支气管肺泡灌洗取样,对比不同取样方法的病原学培养的阳性率及取样过程中发生的不良事件。结果气管镜直接吸引、支气管肺泡灌洗病原学培养阳性率较高,分别为52.8%、59.7%;保护性毛刷、常规吸痰培养的阳性率分别为34.7%、33.3%。结论对于重症肺炎合并呼吸衰竭的患者进行气管镜取样做病原学检查,进而获得准确、可靠的信息,最好能综合经气管镜直接吸引取样、保护性毛刷及支气管肺泡灌洗3种方法。

Objective To evaluate the pros and cons of 3 kinds of pathogen sampling methods, bronchoscope direct attracting, bronchial alveolar lavage and the protective specimen brushing. Methods Seventy - two severe lung infection patients with invasive mechanical ventilation support were recruited in the study. All patients underwent bronchoscopy examination by protected specimen brush, bronchoalveolar lavage and suction. To compare the positive rates of pathogenic culture and the adverse events during the sampling of different sampling methods. Results The positive rate for pathogen culture of suction through bronchoscopy and bronchoalveolar lavage were higher, with 52.8% and 59.7% , respectively; while, that of specimen brush and suction through tube were 34.7% and 33.3%, respectively. Conclusion Patients with severe pneumonia complicated with respiratory failure were performed for bronchoscopic sampling for the etiological examination, in order to obtain accurate and reliable information, it is best to combine with bronchoscope direct attracting sampling, protective specimen brushing and bronchial alveolar lavage.