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 Mycoplasma pneumoniae pneumonia in children

目的：探讨儿童重症肺炎支原体肺炎（MPP）的临床特点及预后。方法选取本院2010年1月-2013年6月105例重症MPP患儿（重症组），并选取同时期105例轻症MPP患儿作为对照组，分析比较两组临床特点及治疗预后情况。结果重症MPP大部分临床症状有咳嗽、高热，高热持续时间长，极易有气促、心动过速现象，有的还会出现发绀、三凹征症状，经肺部影像学检测一般会显示大片状阴影，伴或不伴肺不张症状、胸腔积液、坏死性肺炎等肺内严重并发症，还有的患者出现呼吸系统、神经系统、循环系统、消化系统、泌尿系统等均出现功能受损现象。重症MPP患者中有16例发生闭塞性支气管炎症状。17例重症患儿随访只有4例基本好转，肺功能恢复正常；其余经肺部高分辨CT检查有肺不张现象。结论临床症状严重、发热持续时间长、肺部影像学呈现大片状阴影，合并肺不张等肺内严重并发症患者或存在系统功能受损严重MPP患儿，需予以高度关注并及早予以治疗，若重症MPP患者出现遗留性肺结构及功能受损现象，需予以肺部高分辨CT检查并长期随访。

Objective To investigate the clinical characteristics and prognosis of children mycoplasma pneumoniae pneumonia （MPP）. Methods In our hospital from January 2010 to June 2013 105 cases of children with severe MPP （severe group）, and select the same period 105 cases of mild MPP patients as control group, analysis of two groups of clinical characteristics and prognosis. Results The most severe MPP clinical symptoms were cough, fever, high fever lasted for a long time, extremely easy to have shortness of breath, Beckoning tachycardia phenomenon, there will be some cyanosis, three concave syndrome, pulmonary imaging detection will generally show large patchy shadows, with or without pulmonary atelectasis, pleural effusion, symptoms of necrotizing pneumonia such pulmonary serious complications, and patients with respiratory system, nervous system, circulatory system, digestive system, urinary system were functionally impaired phenomenon. There were 16 cases of bronchiolitis obliterans syndrome in patients with severe MPP. 17 severe cases were followed up only 4 cases largely improved, pulmonary function returned to normal;the rest of the lung high resolution CT examination was of atelectasis phenomenon. Conclusion The clinical symptom severity, duration of fever has big shape shadow, long, imaging, there is a serious complication in patients with severe damage in children with MPP or system function with pulmonary atelectasis, pulmonary, and needs to be attention and be treated as soon as possible, if the patients with severe MPP left lung structure and function damage phenomenon, should be the lungs high resolution CT examination and long-term follow-up.