节段性肺炎支原体肺炎69例

Segmental Mycoplasma Pneumoniae Pneumonia in 69 Children

目的探讨节段性肺炎支原体肺炎（SMPP）的临床特点、肺外并发症和诊治措施。方法对有呼吸道症状和体征、胸片呈节段性肺炎改变、血清肺炎支原体抗体（MP-IgM）阳性的SMPP患儿69例（男35例，女34例；年龄6个月～14岁）的临床表现、实验室及胸片检查、肺外并发症、治疗与转归进行回顾性分析。结果发病多集中在学龄前及学龄期儿童，其中〉5～10岁33例。发热55例；持续性咳嗽65例。其中喘息8例，于咳45例，早期表现流鼻涕7例；右肺肺炎38例，左肺肺炎23例，同时累及双肺8例。并发症：并胸膜炎9例、胸腔积液1例；32例有肺外并发症，其中有消化和泌尿系统并发症各8例（11．6％），心血管系统并发症3例（4．3％），出现神经系统症状和皮肤改变各4例（5．8％），血液系统并发症5例（7．2％），多脏器损害8例（11．6％）。59例先予静脉滴注红霉素，后改阿奇霉素口服治疗，10例仅口服阿奇霉素治疗。33例痊愈，36例好转。结论SMPP好发于学龄儿童，SMPP肺外并发症较严重，红霉素、阿奇霉索序贯治疗安全、疗效尚满意。有必要提高对SMPP的认识，以便尽早诊断和采取合适治疗。

Objective To explore the clinical characteristic, complication of besides lung, diagnosis and therapy of segmental mycoplasma pneumoniae pneumonia （SMPP） in children. Methods Sixty - nine patients （35 males, 34 females, aged from 6 months to 14 years） were selected as researching case,which had symptoms and signs of respiratory in clinic, the chest X -ray shown segmental pneumonia and mycoplasma pneumoniae antibody of serum（ MP- IgM） were positive. All cases were analyzed about clinical manifestation, laboratory arid sternite results,complicatlon of lung outside, treatment and turnover, et al. Results The ages of those majority patients were concentrated in preschool and school children,such as the total patients whose ages were 〉 5 - 10 years old were 33 cases;febrile children were 55 cases, persistent cough in 65 cases,among of those cases,the wheezing were 8 cases,nonproductive cough 45 cases,nasal discharge 7 cases in early right lung pneumonia in 38 cases, left lung pneumonia in 23 cases, pulmones involved at same time were 8 cases. Among of those children who senerated plenritis were 9 cases ,pleural effussion 1 case;complication besides lung appeared 32 children. Complication of digestive and urinary system had 8 cases （ 11.6% ） , respectively. Complication of cardiovascular system had 3 cases （4.3 % ）. Complication of nervous system and skin had 4 cases （5.8%） , respectively. Complication of hematological system had 5 cases （7.2%）. Eight cases （ 11.6% ） showed damage of no more one organ,Fifty- nine cases first treated by erythromycin in vein, then by azithromycin in oral, 10 cases were treated by azithromycin oral medication. Thirty - three cases fully recovered,36 cases improved. Conclusions SMPP are more founded in school children, the complication of besides lung are more serious than that of non - segmental pneumonia, it is security and relatively satisfaction to treat with erythromycin and azithromycin in sequential theraov.