在儿科重症监护病房呼吸道危重症患儿病因诊断中的应用  

Application of pathogeny culture results of BALF in the critical patients with respiratory diseases

作　　者：周丹[1] 许煊[2] 

机构地区：[1]北京铁路局疾病控制中心检验科,北京100700 [2]北京军区总医院附属八一儿童医院儿童重症科,北京100700

出　　处：《中国临床医生杂志》2015年第4期37-39,共3页Chinese Journal For Clinicians

基　　金：十二五国家科技支撑计划项目(2012BA04B01)

摘　　要：目的探讨纤维支气管镜下取支气管肺泡灌洗液培养在儿科重症监护病房(PICU)呼吸系统危重症患儿病因诊断中的应用价值。方法对189例呼吸系统危重症患儿实施纤维支气管镜检查。将纤维支气管镜嵌入节段支气管中,向肺段注入生理盐水,进行支气管肺泡灌洗,然后将其吸出,进行病原学诊断。结果 189例患儿中,痰培养阳性56例,阳性率为29.6%,革兰阴性杆菌阳性35株,革兰阳性球菌阳性21株;支气管肺泡灌洗液定量培养阳性80例,阳性率42.3%,其中革兰阴性杆菌51株,革兰阳性球菌21株,真菌8株。根据灌洗液培养结果和药敏及时调整了治疗方案,患儿临床症状、体征均好转转出PICU入普通病房。结论支气管肺泡灌洗液直接取材于病变部位,阳性的培养结果更好地指导临床选择有效抗菌药物。Objective To explore the role of pathogeny culture results of BALF in the critical patients with severe re- spiratory diseases of PICU. Method One hundred and eighty-nine cases of severe respiratory diseases had undergone FFB from Jul 2012 to Jan 2014. One hundred and fifty-seven（83.06% ） cases were less than 3 years. FFB examina- tions were made through nose （226 times ） and endotracheal intubation （ 25 times）. Bronchoscopic lavagc for bacterial culture was performed by injecting normal saline solution （NSS）via a syringe into the working channel of FFB. Re- sult Of all 189 cases, bacteria were isolated from 80 cases （42.3 % ）for bacterial culture of bronchoscopic lavage flu- id,which included G-bacilli in 51 cases, G＋cocci in 21 cases, and fungi in 8 cases. Conclusion BALF culture is an effective method to find the pathogens.

关 键 词：支气管肺泡灌洗 儿童重症监护病房 呼吸系统疾病 细菌培养 

分 类 号：R563.12[医药卫生—呼吸系统]