Correa A G
Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
Semin Respir Infect. 1996 Sep;11(3):131-8.
Pneumonia in children may be caused by a variety of agents each requiring a different treatment approach. Lack of a simple and reliable method for establishing an etiologic diagnosis in most cases forces the physician to make therapeutic decisions based on the age of the patient, clinical presentation, radiographic findings, and the knowledge of the likely organisms. When a more specific diagnosis is sought, several noninvasive and invasive techniques are available. Among the first group are sputum examination, cultures of blood, sputum and respiratory tract specimens, rapid antigen detection tests, and serology. Those in the later group, which is usually reserved for critically ill patients or those with underlying immunodeficiency, include pleurocentesis, bronchoalveolar lavage, transbronchial biopsy, and open-lung biopsy. The indications and potential advantages of these tests are discussed in this review.
儿童肺炎可能由多种病原体引起，每种病原体都需要不同的治疗方法。在大多数情况下，由于缺乏一种简单可靠的方法来进行病因诊断，医生不得不根据患者的年龄、临床表现、影像学检查结果以及对可能病原体的了解来做出治疗决策。当需要更明确的诊断时，可以采用几种非侵入性和侵入性技术。第一类技术包括痰液检查、血液、痰液和呼吸道标本培养、快速抗原检测试验以及血清学检查。第二类技术通常用于重症患者或存在潜在免疫缺陷的患者，包括胸腔穿刺术、支气管肺泡灌洗、经支气管活检和开胸肺活检。本文将讨论这些检查的适应证和潜在优势。
