儿童重症肺炎支原体肺炎的临床特点及预后

Clinical Characteristics and Prognosis of Severe Mycoplasmal Pneumonia in Children

目的总结儿童重症肺炎支原体肺炎的临床特点及预后。方法选择梧州市人民医院2016年1月—2019年1月收治的118例重症肺炎支原体肺炎患儿为研究对象,总结患儿的临床特点,包含1~12月份的发病情况、临床症状和体征、病变部位和病变类型、并发症发生情况以及对系统功能的损害情况。确诊后给所有患儿采用阿奇霉素联合激素治疗,分析患儿预后情况。结果患儿全年发病共有两个高峰期,分别为1月份和7月份;患儿均存在发热、咳嗽等症状,同时部分患儿还出现心动过速、气促、三凹征症状;患儿病变多累及2个肺叶以上;患儿病变类型主要表现为斑片状或云絮状阴影和大片状阴影;患儿并发症主要有胸腔积液、肺不张、肺脓肿、肺纤维化,其中以胸腔积液发生率最高;共22例患儿发生系统功能损伤(包含4例呼吸系统损害、12例消化系统损害、1例泌尿系统损害、3例血液系统损害、2例神经系统损害);经及时治疗,未有患儿死亡,患儿发热、咳嗽、心动过速、气促等症状消失,行影像学检查显示肺内部病变吸收、肺部纤维化消失,未见斑片状或云絮状阴影和胸腔积液、肺不张等。结论掌握儿童重症肺炎支原体肺炎的临床特点,指导临床尽早对患儿进行确诊和治疗,能有效降低患儿死亡率、改善预后,从而使其获得满意的预后效果。

Objective To summarize the clinical features and prognosis of severe mycoplasmal pneumonia in children.Methods A total of 118 children with severe pneumonia mycoplasma pneumonia admitted to Wuzhou people’s Hospital from January 2016 to January 2019 were selected as subjects.The clinical features of the children were summarized,including the onset,clinical symptoms and signs,and lesions from January to December.The location and type of lesions,complications,and damage to systemic function were determined.All patients were treated with azithromycin combined with hormone therapy to analyze the prognosis of the children.Results There are two peak periods in the whole year,including January and July.The children have symptoms such as fever and cough.At the same time,some children also have symptoms of tachycardia,shortness of breath and three concave signs.More involved in more than 2 lungs;children with lesions mainly showed patchy or cloudlike shadows and large-scale shadows;the complications of children mainly include pleural effusion,atelectasis,lung abscess,pulmonary fibrosis Among them,the incidence of pleural effusion was the highest;a total of 22 children had systemic functional impairment(including 4 cases of respiratory damage,12 cases of digestive system damage,1 case of urinary system damage,3 cases of blood system damage,2 cases of nervous system damage)After treatment,no child died.After treatment,the child’s fever,cough,tachycardia,shortness of breath and other symptoms disappeared.Imaging examination showed that the internal lung lesions were absorbed,the pulmonary fibrosis disappeared,and no spots were found.Flaky or cloud-like shadows and pleural effusion,atelectasis,etc.Conclusion Mastering the clinical features of severe mycoplasma pneumoniae in children and guiding the diagnosis and treatment of children as soon as possible can effectively reduce the mortality and improve the prognosis of children,so that they can obtain satisfactory prognosis.