儿童重症肺炎支原体肺炎10例临床分析  

Clinical analysis of children with severe mycoplasma pneumonia in 10 cases

作　　者：张喜凤[1] 张春秀[1] 石红蕾[1] 钱立伟[1] 

机构地区：[1]山东省聊城市第二人民医院小儿二科,临清252601

出　　处：《中国实用医刊》2010年第23期11-13,共3页Chinese Journal of Practical Medicine

摘　　要：目的 探讨重症支原体肺炎(MPP)患儿的临床特征、治疗方案和转归,以利早期识别重症支原体肺炎,并且把握治疗时机进行合理治疗.方法 对10例重症支原体肺炎患儿的临床资料进行回顾性分析,并进行随诊.结果 与轻症组相比,重症支原体肺炎患儿入院前发热天数、总发热天数明显增多,外周血白细胞总数及C-反应蛋白明显增高,血沉增快,IgM、IgE水平明显增高.10例重症支原体肺炎患儿中,急性期10例肺实变,6例合并中至大量胸腔积液,其中1例合并支原体脑炎.10例患儿治疗除应用抗生素外均加用糖皮质激素,疗效满意,恢复期2例患儿遗留闭塞性细支气管炎,1例遗留中枢神经系统后遗症.结论 对于临床上有上述表现的重症肺炎患儿应考虑到MPP的可能性,治疗上除应用大环内酯类抗生素外,可加用利福平、糖皮质激素治疗.Objective To study the clinical characteristics, therapeutic regimen and outcome of severe mycoplasma pneumonia (MP) in children.Methods Clinical data of 10 children with severe mycoplasma pneumonia were retrospectively analyzed and followed-up.Results In severe MP cases, the fever duration prior to hospitalization and the total fever duration were more prolonged, peripheral blood leucocytes counts, C-reactive protein and erythrocyte sedimentation rate increased, and serum IgM and IgE levels increased as compared to mild MP cases. Of the 10 cases of severe MP, 10 manifested as pulmonary consolidation, 6 as pulmonary consolidation complicated with moderate to large pleural effusion and with 1 of them complicated with central nervous systen mycoplasma infection. Ten severe MP cases were administered with glucocorticoid as well as antibiotics, and the therapeutic effect was satisfactory. In the convalescence stage, 2 cases were complicated with bronchiditis obliterans.Conclusions Severe MP is characterized by rapid progression, pulmonary consolidation, moderate to severe pleural effusion, obviously increased inflammatory indexes, and poor therapeutic reaction to simple macrolide antibiotics. Besides antibiotics,rifampin, glucocorticoid should be used for severe MP cases as soon as possible.

关 键 词：支原体肺炎 糖皮质激素 儿童 

分 类 号：R725.6[医药卫生—儿科]