结核病试验室诊断技术及其进展-结核病防治网.ppt

标准 2. 所有肺结核的可疑症状者都应该进行痰涂片显微镜检查（至 少两次痰涂片检查，至少包含一份晨痰） STANDARD 2. All patients (adults, adolescents, and children who are capable of producing sputum) suspected of having pulmonary tuberculosis should have at least two, and preferably three, sputum specimens obtained for microscopic examination.When possible, at least one early morning specimen should be obtained. 诊 断 Diagnosis 标准 3. 所有的肺结核可疑症状者，都应该对其病变部位来源的合格标本 进行显微镜涂片检查，如果条件允许可以做培养和组织病理学检查。 STANDARD 3. For all patients (adults, adolescents, and children) suspected of having extrapulmonary tuberculosis, appropriate specimens from the suspected sites of involvement should be obtained for microscopy and, where facilities and resources are available, for culture and histopathological examination. 诊 断 Diagnosis 标准 4. 所有胸部影象学检查可疑肺结核的病人，应该对其痰标本进行微生 物学检查。 Standard 4. All persons with chest radiographic findings suggestive of tuberculosis should have sputum specimens submitted for microbiological examination. 诊 断 Diagnosis 标准 5. 涂阴肺结核的诊断标准：至少 3 个痰涂片检查阴性；胸部影象学检 查可疑肺结核；对广谱抗生素试验性治疗无效（除外喹诺酮类）。对这 样的病人如果条件允许，应该做培养；对已知或疑似 HIV 感染者，应加快 对其的诊断进程。 STANDARD 5. The diagnosis of sputum smear-negative pulmonary tuberculosis should be based on the following criteria: at least three negative sputum smears (including at least one early morning specimen); chest radiography findings consistent with tuberculosis; and lack of response to a trial of broad-spectrum antimicrobial agents. (NOTE: Because the fl uoroquinolones are active against M. tuberculosis complex and, thus, may cause transient improvement in persons with tuberculosis, they should be avoided.) For such patients, if facilities for culture are available, sputum cultures should be obtained. In persons with known or suspected HIV infection, the diagnostic evaluation should be expedited. 诊 断 Diagnosis 标准 6. 对有症状的涂阴儿童胸腔结核患者的诊断应该根据胸部影象学检查 可疑肺结核、暴露史或结核感染（ TST 阳性或 γ 干扰素释放试验）。对这样 的病人如果条件允许，应该通过（排出物、洗胃或引痰等方式）得到痰标 本进行培养。 STANDARD 6. The diagnosis of intrathoracic (i.e.,