Torzillo P J, McWilliam D B, Young I H, Woog R H, Benn R
Br J Dis Chest. 1985 Apr;79(2):125-31.
The diagnosis of pulmonary infection remains a major problem in the management of intubated patients with respiratory failure. We performed fibreoptic bronchoscopy and protected telescoping catheter brushing in 25 such patients, in order to assess the role of this technique in the diagnosis of bacterial pulmonary infection. All patients were intubated, demonstrated lung field opacities on chest radiograph and 23 had bacteria grown from tracheal aspirate culture. A single microorganism was recovered from plugged telescoping catheter (PTC) brush in eight patients, two or more organisms in nine patients and eight had a sterile culture. These results led to a specific management decision in 13 patients. All patients were ventilated with positive pressure and a pneumothorax, attributable to the procedure, developed in two. The difficulties in assessing the sensitivity and specificity of this technique in human studies are outlined. This procedure appears to have a useful role in the diagnosis of pneumonia in these patients and in further evaluating the importance of bacterial colonization of the airways and its relationship to parenchymal lung infection.
肺部感染的诊断仍然是呼吸衰竭插管患者管理中的一个主要问题。我们对25例此类患者进行了纤维支气管镜检查和保护性套叠导管刷检，以评估该技术在细菌性肺部感染诊断中的作用。所有患者均已插管，胸部X光片显示肺野有混浊，23例患者的气管抽吸培养物中培养出细菌。在8例患者的堵塞套叠导管（PTC）刷检中分离出单一微生物，9例患者分离出两种或更多种微生物，8例培养结果无菌。这些结果使13例患者做出了具体的治疗决策。所有患者均接受正压通气，2例因该操作发生了气胸。概述了在人体研究中评估该技术敏感性和特异性的困难。该操作在这些患者的肺炎诊断以及进一步评估气道细菌定植的重要性及其与肺实质感染的关系方面似乎具有有用的作用。
