儿童大叶性肺炎85例临床分析

Clinical study of 85 cases of lobar pneumonia in children

目的 分析儿童大叶性肺炎的临床特征,指导临床治疗.方法 对85例大叶性肺炎病例进行回顾性分析.结果 ①学龄儿童多见(64.7%),幼儿亦非少见(35.3%);②发热(100%)、咳嗽(98.82%)为主要临床表现,多为高热(T＞39 ℃)(83.53%);早期多为干咳,病程中出现咳痰(78.82%);③痰培养阳性9例(阳性率23.08%);血培养阳性5例(阳性率9.43%);血清肺炎支原体抗体(MP-IgM)阳性51例(阳性率64.56%);白细胞计数64.71%在正常范围.结论 大叶性肺炎病原种类多样,临床表现不典型,应加强实验室检查,及早明确诊断,合理治疗;MP感染引起的大叶性肺炎发病率有上升趋势,应引起重视.

Objective To investigate the clinical characters of lobar pneumonia in children for reference of clinical strategy. Methods The clinical datas of 85 lobar pneumonia patients that were diagnosed and treated from July 2003 to July 2009 were analyzed.Results ①The majority of them were school-age children, while young children were not rare; the rate was 64.7% and 35.3% respectively. ②Fever and cough were the main clinical manifestations, mostly for high fever; most of them had cough without sputum firstly, and then sputum occurred. ③The positive rate of sputum culture was 23.08%, 9.43% for blood culture, and 64.56% for MP-IgM in the serum; and white blood cell count was in the normal range in 64.71% patients.Conclusions The pathogen of lobar pneumonia was diverse, and clinical manifestations of lobar pneumonia were not typical. For making early diagnosis, clinical laboratory tests should be strengthened, then we could offer proper treatment.Lobar pneumonia caused by MP infection tendedtoincrease, calling for much more attention.