一次性防污染毛刷在重型颅脑创伤患者肺部感染中的应用  

Application of bronchoscopic protected specimen brush in patients with severe traumatic brain injury complicated with pulmonary infection

作　　者：曹月琴[1] 张闻闻[2] 季猛[2] 孙吉林[2] 徐亦农 张靖[2] 赵彤[2] 张勇[1] 孙芳[3] 耿秀霞 

机构地区：[1]泰州市第四人民医院呼吸科,江苏泰州225300 [2]泰州市第四人民医院神经外科,江苏泰州225300 [3]泰州市第四人民医院感染管理科,江苏泰州225300

出　　处：《临床肺科杂志》2017年第10期1837-1839,共3页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨经支气管镜一次性防污染毛刷刷检结合细菌定量培养在重型颅脑创伤并发肺部感染患者中病原学诊断的应用价值及临床疗效。方法选取2013年6月至2015年12月收住我院神经外科重症监护病房重型颅脑创伤患者98例。先后予经支气管镜一次性防污染毛刷刷检和一次性吸痰管采集下呼吸道分泌物进行细菌定量培养,比较二者分离的致病菌阳性率。结果共采集196份标本,防污染毛刷分离的致病菌102株(57.0%),吸痰管抽痰法77株(43.0%)。致病菌检出阳性率相互比较有统计学意义(P<0.05)。培养出的204株阳性菌中污染菌25株,防污染毛刷8株(3.8%),吸痰管抽痰17株(8.3%),防污染毛刷与吸痰管抽痰法比较,防污染性能更佳,差异有统计学意义(P<0.05)。结论经支气管镜防污染毛刷取样结合细菌定量培养技术,敏感性及特异性高,防污染性能明显优于吸痰管抽痰法,对致病菌的正确判断和敏感抗生素的选择有重要的指导意义,能改善重型颅脑创伤并发肺部感染患者的预后。Objective To explore the value of bronchoscopic protected specimen brush applied in patients with severe traumatic brain injury （sTBI） complicated with pulmonary infection. Methods We retrospectively stud-ied 98 patients with pulmonary infection after sTBI admitted in our NICU from June 2013 to December 2015. All pa-tients were first given tracheal aspiration through disposable sputum collecting cannula and then took samples by bron-choscopic protected specimen brush （PSB）. The positive rate of cultivation was compared. Results From 196 sam-ples isolated, the pathogenic bacterium number of PSB and disposable sputum collecting cannula were 102 （57% ） and 77 （43%）. The positive rate of bacteria cultivation was significant difference between the two groups （ P 〈 0. 05）. The contaminating bacterium number of PSB and disposable sputum collecting cannula were 8 （3.8%） and 17 （8.3%） in all 204 strains of pathogens valid sampling. The pollution prevention performance of PSB was better than disposable sputum collecting cannula, and the difference was significant （ P 〈 0. 05 ） . Conclusion The accu-rate ability and sensibility of PSB is much better than tracheal aspiration through disposable sputum collecting cannu-la, and so is pollution prevention performance. It is helpful in the judgement of pathogens and improving their prognossis.

关 键 词：支气管镜 一次性防污染毛刷 吸痰管 重型颅脑创伤 肺部感染 

分 类 号：R563.1[医药卫生—呼吸系统] R651.15[医药卫生—内科学]