目的 通过评估经鼻高流量湿化氧疗在肺部感染患者中的临床疗效,为肺部感染尤其是重症肺炎的患者呼吸道管理策略提供一定的参考依据.方法 2015年9月至2017年9月,采用方便抽样法选取收治于复旦大学附属华山医院感染科的375例肺部感染患者作为研究对象.依据入组时间将其分为对照组和观察组,对照组接受常规治疗,观察组在对照组的基础上根据病情接受经鼻高流量湿化氧疗.比较两组患者的气管插管例数及预后转归,并比较有无接受经鼻高流量湿化氧疗重症肺炎患者的预后情况.结果 两组患者住院期间插管率、出院后28 d内死亡率比较,差异均无统计学意义(P>0.05);观察组入院时重症肺炎率大于对照组(P<0.05);观察组入院时重症肺炎患者出院后28 d内死亡率小于对照组(P<0.05);观察组接受HHFNC的重症肺炎患者治疗后的呼吸频率、心率、氧饱和度、氧分压均较治疗前有所改善(P<0.05).结论 肺部感染患者例数增多且病情加重,经鼻高流量湿化氧疗能有效改善重症肺炎患者临床症状,值得临床推广使用.

Objective Automatic hematology analyzer was used to screening the abnormal results by seting up the criteria for blood smear review of automated CBC and WBC differential analysis through software and automated slide-maker stainer was used to observe cell morphology.Cell count was confirmed by microscopic observation to improve efficiency and ensure analytic quality.Methods On the basis of the instrument XE-2100 alarm systems and 41 consensus rules recommended by ISLH,the review rules for our department was established.On the basis of WBC differential analysis rules recommended by CLSI and 41 consensus rules recommended by ISLH,one of 1 300 positive sample evaluated by review rules was manually checked according to《Chinese Clinical Laboratory Procedure》.The negative samples,were chosen for morphology analysis.Results The positive predictive value and negative predictive value evaluated by this review rules were 76.63% and 98.5%,respectively.The specificity and sensitivity were 89.34% and 96.25%,respectivly.The total diagnostic efficiency were 77.15%.Conclusions The formulated review rules for XE-2100 automated hematology analyzer can effectively screen the abnormal samples and facilitate the staff to review the samples in the limited time.It can also improve the work efficicency and ensure the analytic accuracy.