摘要
目的 :探讨经纤维支气管镜 (FOB)采样技术包括防污染标本毛刷 (PSB)、支气管肺泡灌洗 (BAL)、防污染肺泡灌洗(PBAL)及经FOB肺活检 (TBLB)在肺部感染病原学诊断中的应用价值。方法 :对 13例具有严重基础疾病临床疑及肺部感染的患者经FOB选择PSB、BAL、PBAL和TBLB采样作病原学诊断。结果 :13例患者均能耐受FOB采样 ,10例得到确诊 ,其中普通细菌感染 5例、结核分枝杆菌感染 3例、真菌感染 1例、系统性红斑狼疮肺部活动性浸润 1例。通过BAL采样得到明确诊断者 8例 ,诊断率 6 1.5 %。防污染支气管肺泡灌洗液和支气管肺泡灌洗液直接涂片革兰染色或特殊染色检查可以得到快速、正确率较高的初步结果 ,提供临床选药。结论 :经FOB采样技术适用于病情严重、病原复杂的肺部感染的病原学诊断 ,其中BAL操作简单、安全 。
Objective: To evaluate the role of fiberoptic b ronchoscopy techniques in the etiologic diagnostic of pulmonary infections. Methods:Thirteen patients of pulmonary infections with severe un derlying diseases underwent fiberoptic bronchoscopy examination by protected spe cimen brush (PSB), bronchoalveolar lavage (BAL), protected BAL(PBAL)or trans br onchosicpic lung biopsy (TBLB). Results:All the 13 patients were well tolerated the specimen col lection by fiberoptic bronchoscopy. The diagnosis of ten patients were confirmed , among them 5 were bacterial infections, 3 tuberculosis, one fungal infection, and one patient of SLE with active pulmonary infiltration. The etiological diagn ostic were established through specimen collection by BAL in 8 patients (61.5%). The etiological diagnostic obtained from the above techniques may guide the rat ional selection of antibiotics. Conclusions:Specimen collection through fiberoptic bronchoscopy techniques may be used in the etiologic diagnostics of severe pulmonary infectio n patients, especially BAL is simple, safe and well tolerated.
出处
《中国抗感染化疗杂志》
2003年第5期273-276,共4页
Chinese Journal of Infection and Chemotherapy
