婴幼儿社区获得性肺炎308例临床分析

Clinical Analysia of Community Acquired Pneumonia in Infants:A Report of 308 Cases

目的探讨婴幼儿社区获得性肺炎(CAP)的临床特点和不同抗菌素的疗效。方法把308例婴幼儿CAP随机分为2组,治疗组予以阿奇霉素,对照组予以头孢呋辛钠,分析患儿症状体征缓解情况、阿奇霉素和头孢呋辛钠疗效以及药物副反应,并调查CAP病原组成以及药物敏感情况。结果研究组患儿的肺部湿性啰音消失时间短于对照组(P≤0.05);有效率高于对照组(P≤0.05);恶心呕吐发生率低于对照组,而皮疹发生率高于对照组(P≤0.05);2组在病原分布类型方面无统计学差异,阿奇霉素对衣原体和支原体感染的敏感程度优于头孢呋辛(P≤0.05)。结论婴幼儿CAP多为复合因素致病原,且衣原体/支原体比例增大,以阿奇霉素为代表的大环内酯类能覆盖绝大多数致病细菌和衣原体/支原体,是目前经验性抗生素治疗婴幼儿CAP的首选药物。

Objective To explore the clinical characteristic and curative effect of antibiotic on community acquired pneumonia （CAP） in infants. Methods There were 308 infants with CAP who were randomly divided into 2 groups： infants in research group（ group A） were treated with Azithromyein,eontrol group（ group B） with eeftriaxone, Curative effect, side effect of antibiotic, etiological agent of infants CAP and sensitiveness of antibiotic were analysed. Results There was no statistical difference between 2 groups about age,gender and consisting（ P 〉 0.05 ）. The extinction time o.f moist rale in group A was shorter than that in group B（P≤0.05） ,effective rate in group A was higher than that of group B（P≤0.05） ,the nausea and vomiting in group A was less than that in group B （ P ≤0.05 ）, but more about skin rash （ P ≤〈0.05 ）. There was no difference about distribution of etiological agent in 2 groups, but ehlamydia and myeoplasma were more sensitive to Azithromyein than to eeftriaxone （ P ≤ 0. 05 ）. Conclusions The infants CAP was caused more by composite pathogens, and the ratio of ehlamydia and myeoplasma infection has increased. Maerolides can cover most pathogens of children CAP, and it becomes the first choice of experiential therapy.