Hoeprich P D
Calif Med. 1970 Feb;112(2):1-8.
Decision as to the role of infection in lower respiratory tract disease requires examination by culture of specimens known to be derived from the infra-laryngeal respiratory tract. Methods that involve the upper respiratory tract in collection of specimens entail the hazard of contamination by microbiota resident in the upper respiratory tract.The extrapulmonary approaches of cutting-needle biopsy and needle aspiration of intrathoracic disease have not been impressively productive of etiologic diagnosis of infections. While open-chest surgical biopsy has been a highly effective means to diagnosis, this approach does have special requirements in facilities and technical skills.Percutaneous transtracheal aspiration of tracheo-broncho-pulmonary secretions-exudates has been productive of useful information. Because of inherent simplicity and safety, transtracheal aspiration should precede resort to more demanding, difficult, dangerous procedures.
确定感染在下呼吸道疾病中的作用需要通过对已知源自喉下呼吸道的标本进行培养来检查。在标本采集过程中涉及上呼吸道的方法存在被上呼吸道常驻微生物群污染的风险。经皮穿刺活检和胸腔内疾病针吸等肺外方法在感染病因诊断方面的成效并不显著。虽然开胸手术活检一直是一种高效的诊断手段，但这种方法在设施和技术技能方面确实有特殊要求。经皮气管抽吸气管-支气管-肺分泌物-渗出物已产生了有用信息。由于其固有的简单性和安全性，气管抽吸应在采用要求更高、更困难、更危险的程序之前进行。
