肺部感染和非感染性疾病鉴别诊断的临床思维

Differential diagnosis of infectious and non-infectious lung diseases

肺部感染和非感染性疾病的鉴别诊断非常困难,掌握正确的临床思维具有重要的意义。重视详细的病史采集和物理检查,客观评价实验室检查结果,加强影像学诊断和鉴别诊断的能力,积极稳妥地开展介入性检查,把握好经验性治疗的技巧是临床医生需要把握的几项重要原则。对感染性疾病要进行不同病原微生物的鉴别,对非感染性疾病要有强烈的诊断意识,才能避免误诊和漏诊。

It is very difficult to distinguish infectious lung diseases from no-infectious ones, and a correct practice guideline is of great significance. There are several important principals for physicians in dealing with the situation：collection of a detailed patients＇ history and physical examination information,objective evaluation of laboratory findings, an ability of imaging diagnosis and differential diagnosis, prompt invasive procedure with caution, and skillful empiric treatment. Different pathogens should be tested for infectious lung diseases. The non-infectious lung diseases should be handled with strong sense of caution, so as to avoid misdiagnosis and missed diagnosis.