Wallace J M, Batra P, Gong H, Ovenfors C O
Am Rev Respir Dis. 1985 Mar;131(3):389-92. doi: 10.1164/arrd.1985.131.3.389.
Fourteen patients with acquired immunodeficiency syndrome (AIDS) or suspected AIDS underwent percutaneous needle lung aspiration (PNLA) for evaluation of 16 occurrences of acute pneumonitis. A 22-gauge spinal needle was passed 2 to 3 times in the area of greatest radiographic involvement under fluoroscopic guidance. The specimen was immediately placed on microscope slides for Gomori's methenamine silver and Papanicolaou staining. The needle was then flushed with sterile water for bacterial, Legionella, viral, mycobacterial, and fungal cultures, and for Legionella immunofluorescent staining. Diagnostic information was provided by 14 of the 16 procedures. Of 11 patients ultimately found to have P. carinii pneumonitis, PNLA specimens were diagnostic in 10 (91%). Infectious agents other than P. carinii also were identified by PNLA, including cytomegalovirus (4 cases), M. avium-intracellulare (1 case), and pyogenic bacteria (3 cases). Complications of PNLA were: pneumothorax in 7 cases (44%), 3 (19%) of which required chest tube evacuation; and minor hemoptysis (less than 50 ml) in 2. The PNLA can be a useful diagnostic procedure in the patient with AIDS and pneumonitis. It has the advantages of being less costly and time-consuming than fiberoptic bronchoscopy. It is, however, frequently complicated by pneumothorax, making it an inappropriate approach for patients with significant respiratory compromise.
14例获得性免疫缺陷综合征（AIDS）或疑似AIDS患者接受了经皮肺穿刺抽吸术（PNLA），以评估16例急性肺炎的情况。在荧光镜引导下，使用22号脊椎穿刺针在影像学表现最严重的区域穿刺2至3次。标本立即置于载玻片上，进行Gomori六胺银染色和巴氏染色。然后用无菌水冲洗穿刺针，用于细菌、军团菌、病毒、分枝杆菌和真菌培养以及军团菌免疫荧光染色。16次操作中有14次提供了诊断信息。在最终确诊为卡氏肺孢子虫肺炎的11例患者中，PNLA标本诊断出10例（91%）。PNLA还识别出了除卡氏肺孢子虫之外的其他感染病原体，包括巨细胞病毒（4例）、鸟分枝杆菌复合群（1例）和化脓性细菌（3例）。PNLA的并发症有：气胸7例（44%），其中3例（19%）需要胸腔置管引流；少量咯血（少于50 ml）2例。PNLA对于患有AIDS和肺炎的患者可能是一种有用的诊断方法。它具有比纤维支气管镜检查成本更低、耗时更少的优点。然而，它经常并发气胸，对于有严重呼吸功能不全的患者来说，这不是一种合适的方法。
