纤支镜和DNA倍体分析系统在细菌性肺炎诊治中的临床应用  

Clinical application of fiberoptic bronchoscope and DNA ploidy analysis system in diagnosis and treatment of bacterial pneumonia

作　　者：单立兵 张建东 龙雄 耿文静 SHAN Libing;ZHANG Jiandong;LONG Xiong;GENG Wenjing(Department of Emergency,Xiaolan Hospital, Southern Medical University, Zhongshan 528415, China;Department of Pathology, Xiaolan Hospital, Southern Medical University, Zhongshan 528415, China)

机构地区：[1]南方医科大学附属小榄医院急诊科,广东中山528415 [2]南方医科大学附属小榄医院病理科,广东中山528415

出　　处：《分子影像学杂志》2019年第3期336-339,共4页Journal of Molecular Imaging

摘　　要：目的探讨纤支镜和DNA倍体分析系统在细菌性肺炎诊治中的临床应用价值。方法收集整理2017年10月~2018年3月南方医科大学附属小榄医院在局麻下行纤支镜诊治的96例细菌性肺炎患者的临床资料,从性别、发病年龄、临床表现、实验室检查结果、影像学检查结果、治疗方法、治疗效果等方面进行系统回顾性分析。结果96例细菌性肺炎患者在局麻下行纤维支气管镜检查及肺泡灌洗治疗,肺泡灌洗液进行DNA倍体分析。其中男39例,女57例,年龄17~92岁。胸部CT表现:双肺病变58例,左肺23例,右肺15例;渗出63例,实变54例;支气管扩张13例,胸腔积液7例。实验室检查:血沉异常64例;感染性标志物:白介素升高42例,降钙素升高78例,免疫球蛋白升高55例;外周血白细胞数目:16例<4×109,(4~10)×109的共68例,(10~20)×109的共12例。纤支镜检查结果:支气管内膜炎96例。灌洗液细菌培养及痰培养阳性0例,均为正常菌群未见致病菌。96例肺炎患者经纤支镜灌洗后87例症状迅速改善,治愈率达90.6%。本研究共23例行支气管灌洗液DNA倍体分析检查,均未见DNA倍体异常细胞。结论局麻下应用纤维支气管镜肺泡灌洗术治疗成人细菌性肺炎方法简单,安全有效。纤支镜检查和DNA倍体分析对成人细菌性肺炎的诊治有一定的价值。Objective To explore the clinical value of fiberoptic bronchoscope and DNA ploidy analysis system in the diagnosis and treatment of bacterial pneumonia. Methods We collected the clinical data of 96 cases of bacterial pneumonia in the Xiaolan Hospital affiliated to the Southern Medical University from October 2017 to March 2018. The systematic retrospective analysis were perfromed to gender, age, clinical manifestation, laboratory examination results, radiographic examination results, treatment methods and curative effect. Results A total of 96 cases of bacterial pneumonia were examined by fiberoptic bronchoscopy and alveolar lavage in local anesthesia. The alveolar lavage fluid was analyzed by DNA ploidy. Among them, 39 male and 57 female were included with age of 17-92 years old. Chest ct manifestations: double lung lesions in 58 cases, left lung in 23 cases, right lung in 15 cases, exudation in 63 cases, real change in 54 cases, bronchial dilatation in 13 cases, pleural effusion in 7 cases. Laboratory Examination: 64 cases of erythrocyte sedimentation rate abnormality, infective markers, elevation of interleukin 42 cases, calcitonin increased in 78 cases,55 cases had immunoglobulin increased. The peripheral leukocytes number: 16 cases were less than 4×109, 68 cases were (4-10)×109, 12 cases were (10-20)×109. Results of fiberoptic bronchoscopy: 96 cases of bronchial membrane inflammation. The bacterial culture of lavage fluid and the positive sputum culture were 0 case of normal flora. In 96 cases of pneumonia, 87 cases were rapidly improved by fiberoptic bronchoscope and the cure rate reached 90.6%. Twenty-three cases received DNA ploidy analysis of bronchial lavage fluid, and no abnormal DNA cells were found. Conclusion The treatment of adult bacterial pneumonia with fiberoptic bronchoscopy under local anesthesia is simple, safe and effective. Fiberoptic bronchoscopy and DNA ploidy analysis are valuable in the diagnosis and treatment of bacterial pneumonia in adults.

关 键 词：纤维支气管镜 肺泡灌洗术 细菌性肺炎 DNA倍体分析 

分 类 号：R563.1[医药卫生—呼吸系统]