中国当代医药
中國噹代醫藥
중국당대의약
PERSON
2015年
21期
114-117,120
,共5页
王立敏%梁显泉%龚修云%刘素琴%韦卫琴%虞晓红%任丽萍%石健
王立敏%樑顯泉%龔脩雲%劉素琴%韋衛琴%虞曉紅%任麗萍%石健
왕립민%량현천%공수운%류소금%위위금%우효홍%임려평%석건
痰标本%肺部真菌感染%痰检结果
痰標本%肺部真菌感染%痰檢結果
담표본%폐부진균감염%담검결과
Sputum specimens%Pulmonary fungal in-fection%Sputum outcome
目的：探讨3种不同标本留取方法对肺部真菌感染患者痰结果的影响。方法选取2008年3月~2014年1月本院收治的512例疑诊肺部真菌感染患者，对其普通咳痰、同期采用一次性无菌吸痰管及纤支镜防污毛刷采集的痰标本行真菌涂片镜检、培养，结合临床资料进行回顾性分析，比较不同方法下痰标本合格率、检出率及临床诊断意义。结果一次性无菌吸痰管吸痰、纤支镜防污毛刷取痰及普通咳痰标本合格率分别为91.02%、92.60%及35.08%，痰涂片直接镜检/培养检出率分别为61.56%/60.09%、63.24%/64.84%及45.38%/33.11%。前2种采样方法标本的检出率比较，差异无统计学意义(P>0.05)，但均显著高于普通咳痰的检出率(P<0.01)。前2种方法采集痰标本检查结果在肺部真菌感染诊断中的敏感度、特异度、阳性预测值及阴性预测值分别为66.76%、97.79%、98.82%、51.55%。结论医师全程督导下行一次性无菌吸痰管与纤支镜防污毛刷采样标本的合格率及检出率有较好的一致性，与普通咳痰比较，均有助于提高肺部真菌感染的诊断率，但一次性无菌吸痰管采样更为简便、经济，适用于基层医疗机构。
目的：探討3種不同標本留取方法對肺部真菌感染患者痰結果的影響。方法選取2008年3月~2014年1月本院收治的512例疑診肺部真菌感染患者，對其普通咳痰、同期採用一次性無菌吸痰管及纖支鏡防汙毛刷採集的痰標本行真菌塗片鏡檢、培養，結閤臨床資料進行迴顧性分析，比較不同方法下痰標本閤格率、檢齣率及臨床診斷意義。結果一次性無菌吸痰管吸痰、纖支鏡防汙毛刷取痰及普通咳痰標本閤格率分彆為91.02%、92.60%及35.08%，痰塗片直接鏡檢/培養檢齣率分彆為61.56%/60.09%、63.24%/64.84%及45.38%/33.11%。前2種採樣方法標本的檢齣率比較，差異無統計學意義(P>0.05)，但均顯著高于普通咳痰的檢齣率(P<0.01)。前2種方法採集痰標本檢查結果在肺部真菌感染診斷中的敏感度、特異度、暘性預測值及陰性預測值分彆為66.76%、97.79%、98.82%、51.55%。結論醫師全程督導下行一次性無菌吸痰管與纖支鏡防汙毛刷採樣標本的閤格率及檢齣率有較好的一緻性，與普通咳痰比較，均有助于提高肺部真菌感染的診斷率，但一次性無菌吸痰管採樣更為簡便、經濟，適用于基層醫療機構。
목적：탐토3충불동표본류취방법대폐부진균감염환자담결과적영향。방법선취2008년3월~2014년1월본원수치적512례의진폐부진균감염환자，대기보통해담、동기채용일차성무균흡담관급섬지경방오모쇄채집적담표본행진균도편경검、배양，결합림상자료진행회고성분석，비교불동방법하담표본합격솔、검출솔급림상진단의의。결과일차성무균흡담관흡담、섬지경방오모쇄취담급보통해담표본합격솔분별위91.02%、92.60%급35.08%，담도편직접경검/배양검출솔분별위61.56%/60.09%、63.24%/64.84%급45.38%/33.11%。전2충채양방법표본적검출솔비교，차이무통계학의의(P>0.05)，단균현저고우보통해담적검출솔(P<0.01)。전2충방법채집담표본검사결과재폐부진균감염진단중적민감도、특이도、양성예측치급음성예측치분별위66.76%、97.79%、98.82%、51.55%。결론의사전정독도하행일차성무균흡담관여섬지경방오모쇄채양표본적합격솔급검출솔유교호적일치성，여보통해담비교，균유조우제고폐부진균감염적진단솔，단일차성무균흡담관채양경위간편、경제，괄용우기층의료궤구。
Objective To explore the influence of sputum specimens by three different collecting methods on sputum outcomes in patients with pulmonary fungal infection. Methods 512 patients with suspected diagnosis of pulmonary fungal infection admitted into our hospital from March 2008 to January 2014 were selected.Ordinary expectoration,dis-posable sterile suction tube and bronchofiberscope anti-pollution brush were used to collect sputum specimens for fun-gal smear and culture.Together with clinical data,a retrospective analysis was implemented aiming at comparing quali-fied rate and detection rate of sputum specimen and clinical diagnostic significance by different methods. Results Qual-ified rates of sputum specimens collected by disposable sterile suction tube,bronchoscopy and sputum stain brush bron-chofiberscope anti-pollution brush and ordinary expectoration respectively was 91.02%,92.60% and 35.08%.Detection rates of smear for direct microscopic examinations /culture on sputum specimens by these three methods respectively-was 61.56%/60.09%,63.24%/64.84% and 45.38%/33.11%.There was no statistical difference in detection rate of the first two sputum specimens (P>0.05),but the detection rates by the first two collecting methods were both significantly higher than that by ordinary expectoration with statistical differences (P<0.01).The sensitivity,specificity,positive predic-tive value and negative predictive value of sputum specimens outcomes collecting by the first two methods in the diag-nosis of pulmonary fungal infection was 66.76%,97.79%,98.82%,51.55%in turn. Conclusion Qualified rate and detec-tion rate of specimens by disposable sterile suction tube and bronchofiberscope anti-pollution brush are in good consis-tency under physician’s full supervision. In comparison with ordinary expectoration,they are both beneficial to improve the diagnosis of pulmonary fungal infection. However,disposable sterile suction tube is more simple and economical,and applicable for grass-root medical organizations.
