摘要
重症监护病房(ICU)患者医院性肺炎的病原学诊断需要一种有效、廉价、安全的方法。该方法应适用于所有机械通气患者和所有icu。本研究的目的是评估三种方法的诊断效果:“盲”支气管刷(Accu-Cath)(保护性标本刷-非纤维支气管镜(pbs -non - BF));纤维支气管镜保护标本刷拭(pbs - bf)和支气管肺泡灌洗(BAL)。我们前瞻性地研究了这三种方法的诊断价值以及74例88例临床怀疑呼吸机相关性肺炎(VAP)患者和22例对照者微生物学结果的一致性。VAP病例也分为24例(n = 24)和64例(n = 64),以及78例(n = 78)和10例(n = 10)右下叶浸润。三种技术的细菌产量没有发现差异。结果一致性高;92%的PSB-BF和BAL;pbs -非bf和BAL的84%; 85% for PSB-nonBF and PSB-BF; and 85% for PSB-nonBF combined with both bronchoscopic techniques. The diagnostic yields in suspected VAP were 66, 59 and 56% for PSB-nonBF, PSB-BF and BAL, respectively. We conclude that "blind" bronchial brushing has similar accuracy to bronchoscopic techniques commonly used in the diagnosis of ventilator-associated pneumonia, constituting an interesting alternative in hospitals where fibreoptic bronchoscopy is not available.