支原体混合感染性患儿肺炎106例临床分析

Clinical Analysis of 106 Cases of Mycoplasma Mixed Infections in Children with Pneumonia

目的:探讨支原体混合感染肺炎患儿的治疗措施及临床疗效。方法:本文选取了我院儿科病房2010年2月～2012年2月收住院治疗的106例MP肺炎病例,对患者进行标本采集和病毒检测,并对其临床表现和治疗进行分析。结果:支原体混合感染性肺炎均有咳嗽症状,部分患儿还存在发烧的情况。不同年龄段患儿支原体混合感染的肺炎的种类有所不同。106例MP肺炎患儿中有56例合并了其病原体感染(52.8%),其中合并病毒感染25例(23.6%),合并肺炎衣原体感染16例(15.1%),合并细菌感染15例(13.2%)。检查出的病毒中,呼吸道合胞病毒10例(9.4%),副流感病毒1型8例(7.5%),腺病毒5例(5.7%),柯萨奇病毒1例(0.9%)、流感病毒A 1例(0.9%),流感病毒B、副流感病毒2型、副流感病毒3型未检出。痰培养阳性11例,分别是:肺炎克雷伯菌4例(3.8%)肺炎链球菌2例(1.9%),大肠埃希菌2例(1.9%),金黄色葡萄球菌2例(1.9%),鲍曼氏不动杆菌1例(0.9%),铜绿假单胞菌1例(0.9%)。结论:MP合并其他病原体感染的儿童肺炎较单纯MP感染性肺炎症状更重,病程更长。在治疗方面,确诊MP感染后,应尽快应用有特效的大环内酯类抗生素阿奇霉素治疗,如疗效不明显时,应考虑合并其他病原体感染,立即做病毒学检测、衣原体及痰培养检查,根据相应检查结果进一步治疗。

Objective：To investigate the therapeutic measures and clinical efficacy of Mycoplasma mixed infection in children with pneumonia.Methods：We selected the pediatric ward of our hospital from February 2010 to February 2012,106 patients received hospital treatment MP pneumonia cases,the patient specimen collection and virus detection,analysis and its clinical manifestations and treatment.Results：Mycoplasma mixed infection pneumonia have cough,some children there is a fever.Different kind of different ages in children with mycoplasma pneumonia infection mixed.In 56 cases out of 106 cases of children with MP pneumonia merged its pathogen infection（52.8%）,which merged virus infection in 25 cases（23.6%）,combined Chlamydia pneumoniae infection in 16 cases（15.1%）,with bacterial infection in 15 cases（13.2%）.Check out the virus,respiratory syncytial virus,10 cases（9.4%）,parainfluenza virus type 1 in 8 patients（7.5%）,to adenovirus 5 patients（5.7%）,Coxsackie virus in 1 case（0.9%）,influenza virus A 1（0.9%）,influenza virus B,parainfluenza virus type 2,parainfluenza virus type 3 were not detected.Sputum culture was positive in 11 cases,respectively： 4 cases（3.8%） of Klebsiella pneumoniae Streptococcus pneumoniae in 2 cases（1.9%）,Escherichia coli in 2 cases（1.9%）,Staphylococcus aureus in 2 cases（1.9%）,Bowman Acinetobacter in 1 case（0.9%）,Pseudomonas aeruginosa（0.9%）.Conclusion：MP childhood pneumonia combined with other pathogens than a simple MP infectious pneumonia symptoms is heavier,duration longer.In terms of treatment,diagnosis of MP infection,should be applied as soon as possible the effects of the macrolide antibiotic azithromycin treatment,treatment was combined with other pathogens,done immediately virological testing,chlamydia and sputum culture examination should be considered,according to the corresponding inspection results further treatment.