3种采样方法在医院获得性肺炎病原学诊断中的价值  

Values of three sampling methods in etiologic diagnosis for hospital-acquired pneumonia

作　　者：韩志强[1] 石峰[1] 田明庆[1] 陈晓萍[1] 

机构地区：[1]衢州市人民医院呼吸内科,浙江衢州324000

出　　处：《中华医院感染学杂志》2012年第24期5668-5669,共2页Chinese Journal of Nosocomiology

基　　金：衢州市科级项目课题(20101103)

摘　　要：目的探讨3种不同的采样方法在医院获得性肺炎(HAP)病原学诊断中的价值,以选择更准确、便捷、经济的病原菌标本采用方法。方法 85例HAP患者分别留取常规咳痰法、经纤维支气管镜防污染毛刷(PSB)和支气管肺泡灌洗(BAL)采样标本,进行培养、分离和鉴定。结果经常规咳痰法、BAL和PSB 3种采样方法病原菌培养阳性率分别为54.1%、83.5%和95.3%,差异有统计学意义(P<0.05);3种采样方法检测出病原菌均以革兰阴性菌为主,分别占82.6%、81.7%和79.0%;分布最多的病原菌为肺炎克雷伯菌、铜绿假单胞菌和金黄色葡萄球菌。结论经PSB临床培养阳性率高,对HAP病原菌诊断具有较高特异性。OBJECTIVE To explore the values of three sampling methods in etiologic diagnosis of hospital-acquired pneumonia（HAP） so as to choose more accurate,more conuenient and more economical dilution method for etiological sampling.METHODS The samples from 85 cases with（HAP） were obtained by expectoration,protected specimen brush（PSB）,and bronchoalveolar lavage（BAL） through fiberbronchoscopy.The culture,isolation,and the identification were performed.RESULTS The positive rates of pathogenic culture with the expectoration,BAL,and PSB were 4.1%,83.5%,and 95.3%,respectively,the differences were statistically significant（P0.05）.The gram-negative bacteria were the common pathogens in the all three methods,with the constituent ratios of 82.6%,81.7%,and 79.0%.Klebsiella pneumoniae,Pseudomonas aeruginosa and Staphylococcus aureus were the dominant species of pathogens.CONCLUSION The positive rate of the clinical culture is high through the PSB which has a high specificity in diagnosis of the pathogens causing HAP.

关 键 词：医院获得性肺炎 病原学 采样方法 诊断技术 

分 类 号：R446[医药卫生—诊断学]