Wunderink R G
Curr Opin Pulm Med. 1996 May;2(3):213-7. doi: 10.1097/00063198-199605000-00009.
The multitude of studies on the diagnosis of pneumonia published in the past year testifies to the fact that the best diagnostic strategy remains undefined. For community-acquired pneumonia, the etiologic agent can be diagnosed in a high percentage of patients if extensive serologic testing is used. Unfortunately, standard diagnostic tools, including blood cultures, have a low yield. Newer diagnostic techniques offer some hope for an etiologic diagnosis at a time when therapeutic decisions can be made. For nosocomial pneumonia in the nonventilated patient, transthoracic needle aspiration appears to have good accuracy with a low complication rate. For ventilator-associated pneumonia, research on diagnostic methods has yielded important insights into the disease process itself. Unfortunately, consensus regarding the most appropriate diagnostic tool has not been achieved.
过去一年发表的大量关于肺炎诊断的研究证明，最佳诊断策略仍不明确。对于社区获得性肺炎，如果采用广泛的血清学检测，相当比例的患者可以诊断出病原体。不幸的是，包括血培养在内的标准诊断工具的阳性率较低。在能够做出治疗决策时，新的诊断技术为病因诊断带来了一些希望。对于非通气患者的医院获得性肺炎，经胸针吸活检似乎具有良好的准确性且并发症发生率低。对于呼吸机相关性肺炎，诊断方法的研究对疾病过程本身有了重要的认识。不幸的是，尚未就最合适的诊断工具达成共识。
