Study On The Application Of Bronchoscopic Alveolar Lavage In The Diagnosis Of DBD Donor Lung Bacterial Infection

Objectives:Lung transplantation is the only effective method for the treatment of end-stage lung diseases.With the rapid development of lung transplantation,the survival rate and quality of life of lung transplant patients after technology have improved significantly.However,the utilization rate of lung donors in my country is still low at present.The main reason is The standard for evaluating the donor lung is relatively strict,and the maintenance of the donor lung has become an important part of it.Among them,the bacterial infection of the donor lung has a great impact on the use of the donor lung.The subject studied the role of bronchoscopic alveolar lavage in the diagnosis of brain-dead donor lung bacterial infections,and explored whether bronchoscopic alveolar lavage is an early and effective method for detecting DBD donor lung bacterial infections,and donating donor lungs for clinical brain death The maintenance provides a scientific theoretical basis.Methods:In the Department of Critical Care Medicine,Ganmei Hospital,Kunming Medical University,from January 1,2018 to December 31,2020,42 patients who met the inclusion criteria for brain-dead donor lung donation and underwent sputum culture and fiberbronchoscope alveolar lavage were analyzed.For the alveolar lavage culture group(experimental group)and the sputum culture group(control group),bronchoscopic alveolar lavage fluid culture,the positive detection rate of sputum culture,and the difference of bacterial flora are used as evaluation indicators,and the relevant data is carried out Statistical analysis to draw conclusions.Results:1 General situation comparisonThere was no statistically significant difference between the two groups of patients in terms of gender,age,height,weight,disease data and disease-related data(P>0.05).2 Comparison of detection rateThe positive detection rate of the overall flora in the alveolar lavage group was 83.3%(35/42),and the positive detection rate of the overall flora in the sputum culture group was 61.9%(26/42).The difference between the two was statistically significant.(McNemar test:P=0.004,P<0.05).3 Comparison of detection rates of various bacterial groupsThe positive detection rate of Klebsiella pneumoniae in the alveolar lavage group was 35.7%(15/42),and the positive detection rate of Klebsiella pneumoniae in the sputum culture group was 21.4%(9/42).There are differences between the two Statistical significance(McNemar test:P=0.031,P<0.05);the positive detection rate of Acinetobacter baumannii in the alveolar lavage group was 31.0%(13/42),and the positive detection rate of Acinetobacter baumannii in the sputum culture group The detection rate was 14.3%(6/42).The difference between the two was statistically significant(McNemar test:P=0.016,P<0.05);the positive detection rate of Staphylococcus aureus in the alveolar lavage group was 23.8%(10/42),the positive detection rate of Staphylococcus aureus in the sputum culture group was 9.5%(4/42),and the difference was statistically significant(McNemar test:P=0.031,P<0.05);for ranking For the top three bacteria,the positive detection rate of the fiberoptic bronchoscopy alveolar lavage group was higher than that of the sputum culture group.Conclusion:1.Fiberoptic bronchoscopic alveolar lavage can play a key role in the evaluation and maintenance of brain-dead donated lungs,and it has certain clinical application prospects.2.Fiberoptic bronchoscopic alveolar lavage has a high diagnostic rate in the diagnosis of bacterial infections in brain-dead donated lungs and has certain clinical value.