中国临床医生杂志
中國臨床醫生雜誌
중국림상의생잡지
CHINESE JOURNAL FOR CLINICIANS
2015年
4期
37-39
,共3页
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
支氣管肺泡灌洗%兒童重癥鑑護病房%呼吸繫統疾病%細菌培養
지기관폐포관세%인동중증감호병방%호흡계통질병%세균배양
Broncho alveolar lavage fluid%Pediatric Intensive Care Unit%Respiratory disease%Pathogen
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。
目的：探討纖維支氣管鏡下取支氣管肺泡灌洗液培養在兒科重癥鑑護病房( PICU)呼吸繫統危重癥患兒病因診斷中的應用價值。方法對189例呼吸繫統危重癥患兒實施纖維支氣管鏡檢查。將纖維支氣管鏡嵌入節段支氣管中，嚮肺段註入生理鹽水，進行支氣管肺泡灌洗，然後將其吸齣，進行病原學診斷。結果189例患兒中，痰培養暘性56例，暘性率為29.6%，革蘭陰性桿菌暘性35株，革蘭暘性毬菌暘性21株；支氣管肺泡灌洗液定量培養暘性80例，暘性率42.3%，其中革蘭陰性桿菌51株，革蘭暘性毬菌21株，真菌8株。根據灌洗液培養結果和藥敏及時調整瞭治療方案，患兒臨床癥狀、體徵均好轉轉齣PICU入普通病房。結論支氣管肺泡灌洗液直接取材于病變部位，暘性的培養結果更好地指導臨床選擇有效抗菌藥物。
목적：탐토섬유지기관경하취지기관폐포관세액배양재인과중증감호병방( PICU)호흡계통위중증환인병인진단중적응용개치。방법대189례호흡계통위중증환인실시섬유지기관경검사。장섬유지기관경감입절단지기관중，향폐단주입생리염수，진행지기관폐포관세，연후장기흡출，진행병원학진단。결과189례환인중，담배양양성56례，양성솔위29.6%，혁란음성간균양성35주，혁란양성구균양성21주；지기관폐포관세액정량배양양성80례，양성솔42.3%，기중혁란음성간균51주，혁란양성구균21주，진균8주。근거관세액배양결과화약민급시조정료치료방안，환인림상증상、체정균호전전출PICU입보통병방。결론지기관폐포관세액직접취재우병변부위，양성적배양결과경호지지도림상선택유효항균약물。
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 lavage 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.
