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广泛应用抗菌素后,呼吸道感染的临床表现与既往有所不同,诊断时要重视临床表现亦要尽可能获得病原诊断。检查病原菌咳痰培养最方便,问题是如何除去上呼吸道常在菌的污染,为此可采用:1.定量培养法:全部痰液捣成匀浆,十倍稀释后作培养,计算菌落数。2.洗涤法:洗去咳痰外部粘液,用内部痰培养出来的细菌估计来自病灶部位。3.冰冻切片培养法:咳痰作冰冻切片,取中心的脓性部分作培养。4.用接种针小心把咳痰粘液部分剔去,取脓性部分作培养。其次是从病灶附近采痰:1.气管穿刺抽吸痰液;2.气管插管吸取痰液,但均不能完全避免上呼吸道细菌的混入;3.肺穿刺直接从病灶部位采取标本作培养,但难以推广,因易合并气胸和脓胸。
After the widespread use of antibiotics, the clinical manifestations of respiratory infections differ from the past, the diagnosis should pay attention to clinical manifestations should also be as far as possible pathogen diagnosis. Check the pathogen sputum culture the most convenient, the problem is how to remove the upper respiratory tract often bacteria contamination, this can be used: 1. Quantitative culture method: all sputum pounded into homogenate, ten times diluted for culture, calculate the number of colonies. 2. Washing method: wash away the sputum of external mucus, with the internal sputum culture bacteria estimated from the lesion. Frozen section culture method: sputum for frozen section, take the center of purulent part for culture. 4. Carefully sputum mucus part of the mucus removed, remove the purulent part of the culture. Followed by the sputum near the lesions: 1. Tracheal aspiration sputum; 2. Tracheal aspiration sputum, but can not completely avoid the upper respiratory tract mixed with bacteria; 3. Lung puncture directly taken from the lesion specimens for culture, But difficult to promote, because of easy merge pneumothorax and empyema.