RICU多药耐药菌定植与感染中采用支气管镜黏膜活检及灌洗的临床鉴定分析

发布时间：2018-04-08 18:42

本文选题：呼吸重症监护病房　切入点：支气管镜　出处：《中华医院感染学杂志》2016年17期

【摘要】：目的研究在呼吸重症监护病房(RICU)应用支气管镜黏膜活检、灌洗以及两者联合应用鉴定多药耐药病原菌的定植和感染的临床意义,为临床治疗和诊断提供参考依据。方法选取2013年9月-2015年8月医院RICU接受治疗的204例患者作为研究对象,按照患者是否感染将患者分成感染组和定植组,其中感染组患者62例,定植组患者142例,两组患者均应用支气管镜黏膜活检,以及取肺泡灌洗液进行病原菌培养。结果感染组、定植组中炎症患者与非炎症患者的平均菌落数分别为2.17±0.48、1.51±0.85、0.82±0.12,VAP发生率分别为33.87%、30.00%、9.82%;感染组的机械通气时间、入住RICU时间长于定植组,APACHEⅡ评分高于定植组,两组比较差异有统计学意义(P0.05);黏膜活检、定量培养、两者合用的特异性、灵敏度、阴性预测值、阳性预测值比较,差异有统计学意义(P0.05)。结论将支气管镜黏膜活检、灌洗应用于RICU患者中多药耐药菌的定植和感染监测,具有较高的诊断价值。
[Abstract]:Objective to study the clinical significance of bronchoscopic mucosal biopsy, lavage and combined application in respiratory intensive care unit (RICU) for the identification of multidrug resistant pathogens (MDR) in order to provide reference for clinical treatment and diagnosis.Methods 204 patients who received RICU treatment from September 2013 to August 2015 were divided into infection group and colonization group according to whether the patients were infected or not. 62 patients in infection group and 142 patients in colonized group were divided into two groups: infected group (62 cases) and colonization group (142 cases).Bronchoscopic mucosal biopsy and alveolar lavage fluid were used for pathogen culture in both groups.The difference between the two groups was statistically significant (P 0.05), and that of mucosal biopsy, quantitative culture, specificity, sensitivity, negative predictive value and positive predictive value of the two groups was significantly higher than that of the control group (P 0.05).Conclusion the application of bronchoscopic mucosal biopsy and lavage in the colonization and infection monitoring of multidrug resistant bacteria in patients with RICU is of high diagnostic value.
【作者单位】：郑州铁路职业技术学院护理学院内科教研室;郑州大学第一附属医院病理科;
【基金】：河南省教育厅科学技术研究重点基金资助项目(132102640139)
【分类号】：R459.7

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