采用首周红霉素疗法治疗儿童肺炎支原体肺炎疗效分析

Clinical Effect of Erythromycin Treatment in the First Week on Mycoplasma Pneumoniae Pneumonia in Children

目的:探讨采用首周红霉素疗法治疗儿童肺炎支原体肺炎(MPP)的临床疗效。方法:将128例非重症MPP患儿随机分为观察组68例和对照组60例。观察组第1周给予红霉素20～30 mg/(kg.d)分2次静脉滴注(简称"首周红霉素疗法"),后2～4周同对照组;对照组第1周给予阿奇霉素10 mg/(kg.d)静脉滴注,1次/d,用3 d停4 d,1周为一个疗程,后视病情继续静脉或改口服给药,序贯治疗3～4个疗程。病情发展成重症者联用第三代头孢菌素和糖皮质激素。观察两组患儿发热、咳嗽、肺部啰音消失时间和重症MPP的发生率。结果:观察组退热时间、止咳时间及啰音消失时间均缩短,与对照组比较差异均有统计学意义(P<0.01);观察组重症MPP较少,与对照组比较差异有统计学意义(P<0.05)。结论:采用"首周红霉素疗法"治疗儿童MPP可以较快缓解临床症状,缩短病程,减少重症MPP的发生。

Objective： To study the clinical effect of erythromycin treatment in the first week on mycoplasma pneumoniae pneumonia （MPP） in children. Methods： Together 128 patients with unsevere MPP were divided into observation group （ n = 68 ） and control group （n=60）. The observation group were treated with erythromycin twice a day in the first week （for short ＂the first week erythromycin treatment＂ ） 20 - 30 mg/（ kg·d）, and they received the same treatment method as the control group in the rest 2 - 4 weeks ; while 60 patients of the control group were treated with azithromyein 10 nag/（ kg·d） once a day for 3 days and stopped for 4 days in the first week. According to the patients＇ condition, intravenous drip or oral therapy were administrated in the following 3 -4 weeks. The third generation eephalosporin and glucocorticoid were used in two groups if the patients＇ condition became worse. To observe the incidence rate of fever and cough, the extinction time of pulmonary rales, and severe MPP in two groups. Results： In observation group, the extinction time of fever, cough, and pulmonary tales were all shorten. The difference between the two groups was statistically significant （P〈0.01） ; the incidence rate of severe MPP was reduced obviously in the observation group and it was different from the control group significantly （P〈0.05）. Conclusions： The application of the ＂first week erythromycin treatment＂ in the treatment of child MPP can relieve clinical symptoms, shorten the course of disease, and reduce the incidence of severe MPP cases.