治疗性应用“限制使用”与“特殊使用”类抗菌药物前，应先进行细菌或真菌培养和药敏

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<p class="MsoNormal" align="left" style="MARGIN: 0cm 0cm 0pt; TEXT-ALIGN: left; mso-pagination: widow-orphan;"><span style="FONT-SIZE: 9pt; COLOR: #333333; FONT-FAMILY: 宋体; mso-bidi-font-family: 宋体; mso-font-kerning: 0pt;">问：治疗性应用</span><span lang="EN-US" style="FONT-SIZE: 9pt; COLOR: #333333; FONT-FAMILY: Arial; mso-font-kerning: 0pt;">“</span><span style="FONT-SIZE: 9pt; COLOR: #333333; FONT-FAMILY: 宋体; mso-bidi-font-family: 宋体; mso-font-kerning: 0pt;">限制使用</span><span lang="EN-US" style="FONT-SIZE: 9pt; COLOR: #333333; FONT-FAMILY: Arial; mso-font-kerning: 0pt;">”</span><span style="FONT-SIZE: 9pt; COLOR: #333333; FONT-FAMILY: 宋体; mso-bidi-font-family: 宋体; mso-font-kerning: 0pt;">与</span><span lang="EN-US" style="FONT-SIZE: 9pt; COLOR: #333333; FONT-FAMILY: Arial; mso-font-kerning: 0pt;">“</span><span style="FONT-SIZE: 9pt; COLOR: #333333; FONT-FAMILY: 宋体; mso-bidi-font-family: 宋体; mso-font-kerning: 0pt;">特殊使用</span><span lang="EN-US" style="FONT-SIZE: 9pt; COLOR: #333333; FONT-FAMILY: Arial; mso-font-kerning: 0pt;">”</span><span style="FONT-SIZE: 9pt; COLOR: #333333; FONT-FAMILY: 宋体; mso-bidi-font-family: 宋体; mso-font-kerning: 0pt;">类抗菌药物前，应先进行细菌或真菌培养和药敏试验</span><span lang="EN-US" style="FONT-SIZE: 9pt; COLOR: #333333; FONT-FAMILY: Arial; mso-font-kerning: 0pt;">.</span><span style="FONT-SIZE: 9pt; COLOR: #333333; FONT-FAMILY: 宋体; mso-bidi-font-family: 宋体; mso-font-kerning: 0pt;">请问</span><span lang="EN-US" style="FONT-SIZE: 9pt; COLOR: #333333; FONT-FAMILY: Arial; mso-font-kerning: 0pt;">:</span><span style="FONT-SIZE: 9pt; COLOR: #333333; FONT-FAMILY: 宋体; mso-bidi-font-family: 宋体; mso-font-kerning: 0pt;">包括所有病人吗</span><span lang="EN-US" style="FONT-SIZE: 9pt; COLOR: #333333; FONT-FAMILY: Arial; mso-font-kerning: 0pt;">?</span><span style="FONT-SIZE: 9pt; COLOR: #333333; FONT-FAMILY: 宋体; mso-bidi-font-family: 宋体; mso-font-kerning: 0pt;">如果是外科胆囊炎、胰腺炎、或者阑尾炎病人该留取什么标本</span><span lang="EN-US" style="FONT-SIZE: 9pt; COLOR: #333333; FONT-FAMILY: Arial; mso-font-kerning: 0pt;">?</span><span lang="EN-US" style="FONT-SIZE: 9pt; COLOR: #333333; FONT-FAMILY: 宋体; mso-bidi-font-family: 宋体; mso-font-kerning: 0pt;">, </span><span lang="EN-US" style="FONT-SIZE: 9pt; COLOR: #333333; FONT-FAMILY: Arial; mso-font-kerning: 0pt;">2007-3-26 16:36<p></p></span></p><p class="MsoNormal" align="left" style="MARGIN: 0cm 0cm 0pt; TEXT-ALIGN: left; mso-pagination: widow-orphan;"><span lang="EN-US" style="FONT-SIZE: 9pt; COLOR: #333333; FONT-FAMILY: 宋体; mso-bidi-font-family: 宋体; mso-font-kerning: 0pt;"><p>&nbsp;</p></span></p><p class="MsoNormal" align="left" style="MARGIN: 0cm 0cm 0pt; TEXT-ALIGN: left; mso-pagination: widow-orphan;"><span style="FONT-SIZE: 9pt; COLOR: #333333; FONT-FAMILY: 宋体; mso-bidi-font-family: 宋体; mso-font-kerning: 0pt;">答：您的问题很好，有一定代表性。其实，仔细想一想就好明白。第一，我们不是要求所有的病人做病原学检查，所以扣分标准起点不是</span><span lang="EN-US" style="FONT-SIZE: 9pt; COLOR: #333333; FONT-FAMILY: Arial; mso-font-kerning: 0pt;">99</span><span style="FONT-SIZE: 9pt; COLOR: #333333; FONT-FAMILY: 宋体; mso-bidi-font-family: 宋体; mso-font-kerning: 0pt;">％；第二，您举的病种，如果要使用高级抗菌药物的话，通常是有高热的，合并菌血症的机会并不少见，这些病人至少应该做血培养两次吧。我国微生物标本送检率太低，病原学诊断太低，已经严重影响了经验性使用抗菌药物的效果，对提高医疗质量颇为不利。</span><span style="FONT-SIZE: 9pt; COLOR: #333333; FONT-FAMILY: Arial; mso-font-kerning: 0pt;">
                </span><span lang="EN-US" style="FONT-SIZE: 9pt; COLOR: #333333; FONT-FAMILY: 宋体; mso-bidi-font-family: 宋体; mso-font-kerning: 0pt;">, </span><span lang="EN-US" style="FONT-SIZE: 9pt; COLOR: #333333; FONT-FAMILY: Arial; mso-font-kerning: 0pt;">2007-3-27 4:22<p></p></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><p><font face="Times New Roman">&nbsp;</font></p></span></p>