深部痰涂片镜检在肺部真菌感染早期诊断中的临床意义.docVIP

精品论文 参考文献 深部痰涂片镜检在肺部真菌感染早期诊断中的临床意义 王立敏1 梁显泉2 龚修云3 刘素琴3 韦卫琴3 虞晓红3（1、贵阳市第一人民医院 550000；2、贵阳市金阳医院 550000；3、贵阳医学院附属医院 550000； 　　【摘要】目的：探讨深部痰涂片镜检在肺部真菌感染早期诊断中的临床意义。方法：采集2008 年3 月-2014 年1 月期间疑诊肺部真菌感染患者的深部痰及普通咳痰行真菌涂片镜检、培养，结合临床资料进行回顾性分析。结果：深部痰合格率91.59%，涂片直接镜检及培养的检出率分别为62.12%、61.67%；普通咳痰合格率35.37%,对应的检出率分别为45.38%、33.61%,两者比较前者合格率、检出率显著高于后者，有统计学意义（Plt;0.001）；深部痰涂片镜检与培养检出率有较好的一致性，无统计学差异（Pgt;0.05）；临床诊断肺部真菌感染376 例，以临床诊断病例为标准，深部痰检的敏感性、特异性、阳性预测值及阴性预测值分别为66.76%、97.79%、98.82%、51.55%，治疗有效率72.18%，相关死亡率27.82%。结论：痰检前涂片镜检筛查合格标本是提高痰检阳性率及可靠性的重要保障；合格深部痰涂片直接镜检可为肺部真菌感染患者提供早诊断依据，实现抢先治疗，尤其适合重症监护病房及基层医疗机构。 　　【关键词】深部痰 涂片直接镜检 肺部真菌感染（PFI）【中图分类号】 R2 【文献标号】 A 【文章编号】 2095-7165（2015）11-0095-03Clinical Value of Deep sputum smear examination which in the early diagnosisand treatment of pulmonary fungal infection in intensive care unit patientsWanglimin1 Liangxianquan2 Gongxiuyun3 Liusuqin3 Weiweiqin3 Yuxiaohong3(The first peoples Hospital of Guiyang City，Guizhou,China 550002; The second peoples Hospital of Guiyang City，Guizhou,China 550003;The AffiliatedHospital Guiyang Medical college,Guizhou,China 550004)[Abstract] Objective: To evaluate the clinical significance that the deep sputum , s smear direct microscopic examination in the early diagnosis andantifungal treatment of pulmonary fungal infection. Methods: Collecting 512 cases patients, deep sputum and common sputum to take sputum smear directmicroscopic and fungal culture who are suspected pulmonary fungal infection during in 2008 march to 2014 january. Finally, combined with the clinicaldata were retrospectively analyzed. Results: Deep sputum qualified rate was 91.59%, significantly higher than The qualified rate of the ordinarysputum35.37%.Deep sputum smear microscopy and culture of direct detection rates were 62.12% and 61.67%, corresponding to the ordinary sputumdetection rates were 45.38% and 33.61%, Statistical analysis showed deep sputum positive rate is obviously higher than that common sputum ,s,(P lt;0.001).Deep sputum smear direct microsco