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1、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%,涂片肓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
2、于后者，有统计学意义(P<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(P>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木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】深部痰涂片盲接镜检肺部真菌感染(PFI)[中图分类号】R2【文献标号】A【文章编
3、号】2095-7165(2015)ll-0095-03ClinicalValueofDeepsputumsmearexaminationwhichintheearlydiagnosisandtreatmentofpulmonaryfungalinfectioninintensivecareunitpatientsWangliminlLiangxianquan2Gongxiuyun3Liusuqin3Weiweiqin3Yuxiaohong3(ThefirstpeoplesHospitalofGuiyangCity,Guizhou,China550002;ThesecondpeoplesHosp
4、italofGuiyangCity,Guizhou,China550003;TheAffiliatedHospitalGuiyangMedicalcollege,Guizhou,China550004)[Abstract]Objective:Toevaluatetheclinicalsignificaneethatthedeepsputum,ssmeardirectmicroscopicexaminationintheearlydiagnosisandantifungaltreatmentofpulmonaryfungalinfection.Methods:Collect!ng512cases
5、patients,deepsputumandcommonsputumtotakesputumsmeardirectmicroscopicandfungalculturewhoaresuspectedpulmonaryfungalinfectionduringin2008marchto2014january.Finally,combinedwiththeclinicaldatawereretrospectivelyanalyzed・Results:Deepsputumqualifiedratewas91.59%,sign讦icantlyhigherthanThequalifiedrateofth
6、eordinarysputum35.37%.Deepsputumsmearmicroscopyandcultureofdirectdetectionrateswere62.12%and61.67%,correspondingtotheordinarysputumdetectionrateswere45.38%and33.61%,Statisticalanalysisshoweddeepsputumpositiverateisobviouslyhigherthanthatcommonsputum,s,(P<0.001).Deepsputumsmeardirectmicroscopyandc
7、ulturepositiverateswere62.12%and61.67%,statisticalanalysisitisnosignificantdifference(P>0.05).Finally376patientswereclinicallydiagnosedaspulmonaryfungalinfection,Incasesofclinicaldiagnosisasthestan
