Research Of Trans-bronchoscopic Catheter Aspiration For The Etiological Diagnosis Of Senile Pneumonia

Objective:To investigate the diagnostic value of different sampling methods under the fiberoptic bronchoscope in senile pneumonia and provide scientific basis to guide the clinical medication.Methods:During August 2017 to August 2018,a total of 70 patients with senile pneumonia from Respiratory Department and Elderly Medical Department in Shaoyang Central Hospital were selected.And 40 patients without pulmonary infection of outpatient were collected.Sputum samples were obtained to culture bacteria through three different sampling methods including the catheter attract under bronchoscope,direct suction via bronchoscopy and bronchoalveolar lavage under bronchoscope.The cultivate pathogen of sputum specimens under three different methods was analyzed.The relevant indicators were compared mainly covering the positive rate and its sensitivity,specific degrees,accuracy,positive predictive value,negative predictive value.Results:A total of 110 patients have no any adverse reactions in the process of the three sampling ways.210 sputum specimens with senile pneumonia are cultivated,positive cultivate bacteria for 122 cases,including 43 cases of acinetobacter baumannii,39 cases of pseudomonas aeruginosa,25 cases of Klebsiella pneumonia,and four cases of klebsiella pneumoniae subspecies,four cases of escherichia colii,two cases of enterobacter cloacae.There is one case of eosinophilic malt oligotrophic,onion bacterium burkholderia bacteria and produce alkali pseudomonas,ornithine klebsiella,meningeal septic golden bacillus,respectively.A total of 120 sputum specimens without lung infection of outpatients are collected.Two cases of pathogenic bacteria are found,which is pneumonia klebsiella pneumonia subspecies and e.coli,respectively.The positive rate of specimens collected by attract catheter under bronchoscope attraction,directly attract and alveolar lavage by bronchoscopy are 77.1%,41.4%and 55.7%,respectively,which is a significant difference(?~2=18.58,P<0.05).There is a mild consistency of three sampling methods in pathogen detection results.The sensitivity of the three sampling methods is 77.1%,41.4%and 77.1%respectively;specific degree is 100.0%,97.5%and 100.0%,respectively;the correct rates is 85.5%,61.8%and 70.9%respectively;positive predictive value is100.0%,96.7%,97.5%;negative predictive value of 71.4%,48.8%and55.7%respectively.Conclusion:The pathogen diagnosis efficiency,sensitivity,specific degree,accuracy,positive predictive value,negative predictive value of catheter attract sampling under fiberoptic bronchoscope is higher than direct suction via bronchoscopy and bronchoalveolar lavage under bronchoscope,which has good value of clinical application.