危重患者中应用自制留痰负压管的价值

The Value of Using Self-made Negative Pressure Tube for Sampling Sputum Specimen in the Critical Care Patients

目的 :改进对出现院内肺部感染且不能自行排痰的危重患者采集痰液进行病原体诊断的方法 ,探讨采用自制负压吸引管收集痰液标本的临床应用价值。方法 :对临床危重患者 (脑血管意外、全身衰竭、重症肌无力、呼吸衰竭 )出现院内肺部感染时按配对方法分为两组 ,对两组患者分别采用负压吸引管收集痰液和常规方法收集痰液 ,比较两种采样的有效性、两组痰液标本的合格率及两组标本的阳性率。结果 :试验组每例患者均用负压管一次性收集到标本 ,采样一次有效者 2 5例 (10 0 % ) ,对照组用常规方法采样的有效者为 15例(6 0 % ) ;试验组标本一次性合格者 2 3例 (92 % ) ,对照组为 8例 (5 3% ) ;试验组标本阳性者 2 2例 (88% ) ,对照组 5例 (6 2 % ) ;两组病例的三项指标比较有明显差异 ,P值均 <0 .0 5。结论

Objective: To improve the method of sampling sputum specimen for the pathogen diagnosis in the critical care patients with hospital acquired pulmonary infection who can not spit sputum. To explore the clinic value of using self-made negative pressure tube for sampling sputum specimen. Methods: According to whether using negative pressure tube or using routine method for sampling sputum specimen, we classified the critical care patients (stroke, exhaustion, myosthenia gravis, respiratory failure) with hospital acquired pulmonary infection into two groups and paired up them based on category, extent, age and sex. The effectiveness of two sampling methods, the rate of certified specimen and the positive rate of two groups specimens were compared. Results: We can get the specimen one-off availably using the negative pressure tube for every patient in trial group. The one-off effectiveness for sampling in trial and controll was 25 (100%) and 15 (60%) respectively. The rate of certified specimens in two groups was 23 (92%) and 8 (53%) respectively. The positive specimens of two groups was 22 (88%) and 5 (62%) respectively. The difference was significant by comparing three indices between two groups of the patients, P< 0.05 (for all three indices). Conclusion: It is very valuable application for the critical care patients with hospital acquired pulmonary infection to use negative pressure tube for sampling the sputum specimen.