儿童重症肺炎支原体肺炎18例临床诊断和治疗  

Clinical diagnosis and treatment of severe Mycoplasma pneumoniae pneumonia in 18 children

作　　者：罗敏[1] 邓瑜琼 刘沧海[1] 方亮[1] 

机构地区：[1]江西省兴国县人民医院儿科,江西兴国342400

出　　处：《中国当代医药》2014年第1期182-184,共3页China Modern Medicine

摘　　要：目的探讨儿童重症肺炎支原体肺炎(MPP)的诊断、治疗及预后。方法对18例重症MPP患儿的临床资料进行回顾性分析。结果未合并胸腔积液、肺实变的2例患儿中,1例经给予阿奇霉素联合第3代头孢类抗生素后,临床症状好转;另外1例症状无好转,经加用激素治疗后症状好转。胸腔中大量积液的8例患儿,予胸腔穿刺引流、药物治疗后,积液量减少。2例患儿对激素过敏,改行抗生素联合丙种球蛋白治疗后,复查胸片示积液吸收。胸腔少量积液的3例患儿,予抗生素联合激素治疗后症状好转。呈节段状、片状肺实变及肺不张的13例患儿,予抗生素联合激素治疗,治疗后7例患儿肺实变、肺不张无明显好转,行纤维支气管镜灌洗后,基本恢复正常。结论儿童重症MPP病情危重,病情发展快,早期诊断、及时合理地选择治疗方式是挽救患儿生命、改善预后的关键。Objective To explore the diagnosis,treatment and prognosis of severe Mycoplasma pneumoniae pneumonia （MPP） in children. Methods The clinical datas of 18 children with severe MPP were retrospectively analyzed. Results Among the 2 children without pleural effusion or pulmonary consolidation,1 case was treated with azithromycin com- bined with cephalosporin antibiotics in 3rd generation,and then the clinical symptoms was improved;and for the other one,after additionally added with hormonotherapy,the symptoms was improved.8 out of 18 children with medium and mass pleural effusion,after thoracocentesis for drainage and drug therapy,the volume of hydrops became decreased.Due to allergy to hormone in 2 children,they were treated by antibiotics combined with gamma globulin,the reexaminations of chest radiograph indicated that the pleural effusion was absorbed.3 children with a small amount of pleural effusion became better after provided with antibiotics and hormones.13 cases with segmental and flaky pulmonary consolidation and atelectasis were treated by antibiotics combined with hormonotherapy,after the treatment,there was no obvious im- provement in 7 cases which were returned to normal after applied lavage by fiber bronchoscope. Conclusion The dis- ease condition of severe MPP in children are critical and fast in development,the key points to save children＇s lives and improve the prognosis are early diagnosis and selection of therapeutic methods timely and reasonably.

关 键 词：儿童 支原体肺炎 重症 治疗 

分 类 号：R375.2[医药卫生—病原生物学]