江苏地区儿童重症肺炎支原体肺炎的临床特征分析  

Clinical analysis on characteristics of severe pediatric mycoplasma pneumonia in Jiangsu province

作　　者：张银美[1] 唐云章[1] 

机构地区：[1]江苏省人民医院,江苏南京210000

出　　处：《实用临床医药杂志》2013年第23期49-51,共3页Journal of Clinical Medicine in Practice

摘　　要：目的了解江苏地区儿童重症肺炎支原体肺炎的临床特征,以提高早期诊断及治疗水平。方法收集2010年7月至2013年4月在本科确诊为重症肺炎支原体肺炎的住院患儿105例,采用酶联免疫吸附法(ELISA)检测MP-IgM抗体,回顾性分析患儿的临床表现、治疗转归等。结果重症肺炎支原体肺炎多以高热伴痉挛性咳嗽为临床主诉,肺部可闻及干、湿罗音68例(64.8%);胸部影像学检查提示肺内病变多累及单侧或双侧肺,易合并胸腔积液及肺不张;单纯大环内酯类抗生素治疗效果欠佳,需联合头孢三代抗生素治疗,部分病例需加用激素和(或)静脉丙种球蛋白;所有患儿预后均良好。结论重症肺炎支原体肺炎病情重、进展快,可引起肺内、外并发症且病情迁延。早期识别、早期积极治疗,大多患者预后良好。Objective To explore the clinical characteristic of severe pediatric mycoplasma pneumonia in Jiangsu province and to ameliorate the early diagnosis and treatment of this disease. Methods A total of 105 patients diagnosed severe pediatric mycoplasma pneumonia from July 2010 to April 2013 were collected. During the treatment, Enzyme linked immunosorbent assay was used to detect the IMP - IgM and clinical manifestation, therapeutic effect and outcome of the diseases were retrospectively analyzed. Results Chief complaints of patients with severe mycoplasma pneu- monia were hyperpyrexia and spasmodic cough. There were moist or dry rales （64.8%） in the lungs of 68 patients. Consequently, imaging examinations shown that the lesion had involved in uni- lateral or bilateral lungs which could incline to cause pleural effusion and pulmonary atelectasis. It was demonstrated that simple macrolide antibiotics had inferior therapeutic effects. However, the addition of the third generation cephalosporins hormone as well as intravenous gamma globulin in some patients had good prognosis. Conclusion Severe mycoplasma pneumonia develops rapidly and causes interior and exterior complications in the lungs. Thus, the early identification and tx^sitive treatment could make patients rehabilitate quickly.

关 键 词：肺炎支原体肺炎 耐药 重症 儿童 

分 类 号：R563.1[医药卫生—呼吸系统]