保护性毛刷盲取技术在念珠菌肺炎病原学诊断中的研究

目的初步探讨应用防污染保护性毛刷盲取技术在念珠菌肺炎病原学诊断中的临床价值.方法采用前瞻性、自身对照临床研究设计,对30例气管切开患者,疑诊肺部真菌感染,采用防污染保护性毛刷经气管套管盲取技术,行下呼吸道标本真菌培养病原学诊断,同时刷片观察组织细胞学及真菌菌丝、孢子体形态学证据.结果30例气管切开患者,采用防污染保护性毛刷经气管套管盲取技术,行下呼吸道标本真菌培养病原学诊断,阳性率为63.33%,与常规无菌吸痰管取标本真菌培养阳性病例相比,两种诊断技术比较无显著的统计学差异.同时与非气管切开病例常规采样真菌培养结果相比两种念珠菌混合感染少,病原污染可能性小,P＜0.05.组织细胞学及真菌菌丝、孢子体形态学证据诊断肺念珠菌感染阳性率为36.67%.结论气管切开病例肺部念珠菌感染,长期联合使用广谱抗生素、低白蛋白血症、中性粒细胞减低比例较高.防污染保护性毛刷盲取技术,可以作为气管切开患者念珠菌肺炎病原学诊断的可靠的取材方法.

The value of blinded protected-specimen brush technique in the pathogenic diagnosis of pulmonary candida infections

Objective To explore the diagnostic value of blinded protected-specimen brush technique in the pathogenic diagnosis of candida infections of pulmonary. Methods A prospectiven, self-controlled clinical trial design, enrolled 30 patients with tracheostomy was conducted during a 8-month period, using protected brush from contamination, aspirating candida species from the lower respiratory samples were cultured. Meanwhile brushingslide samples, autopsy confirmation were performed. Results 30 cases with tracheostomy, be used blinded protected-specimen brush technique, species from lower respiratory samples suspected candida infections were cultured, the positive rate is 63.33%. Compared routine sterile aspirate tube two techniques show no statistical significance and the positive rate of histologic confirmation was 36.67%. Conclusions Receiving inadequate use of broadspetrum antibiotics, lower values of serum albumin neutrphnia are relatively common. Compared PSB sampling to the use of specimens obtained immediately from the lower respiratory samples with non-tracheostomy patients, the culture results were less contamination P<0.05.