经电子支气管镜肺泡灌洗在肺部感染病原学诊断中的应用分析

Analysis of the Application of Electronic Bronchoscopy Alveolar Lavage in the Etiology Diagnosis of Pulmonary Infection

目的探讨经电子支气管镜肺泡灌洗在肺部感染病原学诊断中的应用分析。方法回顾性分析2018年11月至2019年7月在我院呼吸内科治疗的50例肺部感染患者的临床资料,均行电子支气管镜肺泡灌洗治疗,行局部采样,分析细菌培养和药敏试验,评估临床疗效。结果50例肺部感染患者中分离出97株病原菌,其中革兰阴性菌71株(73.20%),革兰阳性菌23株(23.71%),真菌3株(3.09%);革兰阴性菌以鲍曼不动杆菌、铜绿假单胞菌比例最高,革兰阳性菌以金黄色葡萄菌比例最高;对鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌的药敏实验显示,鲍曼不动杆菌和铜绿假单胞菌对大多数抗生素均有较高耐药性,但对阿米卡星、多黏菌素敏感性较高,肺炎克雷伯菌和大肠埃希菌对头孢吡肟、阿米卡星的敏感性较高;经敏感性抗生素治疗后,治疗有效率为96.00%。结论经电子支气管镜肺泡灌洗在肺部感染病原学诊断中的应用效果显著,能有效明确病原菌,根据药敏试验选用敏感性抗生素,治疗效果确切,具有较高应用价值。

Objective To investigate the application and analysis of electronic bronchoscopy alveolar lavage in the etiological diagnosis of pulmonary infection.Methods The clinical data of 50 patients with pulmonary infection treated in the department of respiratory medicine of our hospital from November 2018 to July 2019 were retrospectively analyzed.All patients were treated with electronic bronchoscopy alveolar lavage,local sampling was conducted,bacterial culture and drug sensitivity test were analyzed,and clinical efficacy was evaluated.Results Ninety-seven pathogens were isolated from 50 patients with lung infections,of which 71 were gram-negative bacteria(73.20%),23 were gram-positive bacteria(23.71%),and 3 were fungi(3.09%);the gram-negative bacteria was abalone the proportion of Acinetobacter mannii and Pseudomonas aeruginosa is the highest,and the proportion of gram-positive bacteria is Staphylococcus aureus;the medicines for Acinetobacter baumannii,Pseudomonas aeruginosa,Klebsiella pneumoniae and Escherichia coli Sensitivity test showed that Acinetobacter baumannii and Pseudomonas aeruginosa have high resistance to most antibiotics,but high sensitivity to amikacin,polymyxin,Klebsiella pneumoniae and large intestine Escherichia has a high sensitivity to cefepime and amikacin;after treatment with sensitive antibiotics,the effective rate of treatment is 96.00%.Conclusion The application of electronic bronchoscopy alveolar lavage in the etiological diagnosis of pulmonary infection is significant,can effectively identify pathogenic bacteria,according to the drug sensitivity test to choose sensitive antibiotics,the treatment effect is accurate,has high application value.