婴幼儿支原体肺炎41例临床分析

Clinical Analysis of 41 Cases of Infant and Young Children with Mycoplasma Pneumonia

目的:根据小儿肺炎支原体感染的临床表现和特征,探讨对其诊断与治疗的方法。方法:选取笔者所在医院2011年4月-2014年4月收治的41例肺炎支原体感染患儿作为研究对象,对其临床资料进行回顾性分析。41例均有不同程度的咳嗽、咳痰;其中29例患者有发热病史,34例患者就诊时仅表现为肺部呼吸音减弱或增粗、无干湿啰音。一周后出现湿啰音,伴喘鸣音有9例,呼吸音减低有1例,轻度胸痛5例,病变区叩诊浊音3例,无阳性体征者4例。肺外表现:窦性心动过速4例,窦性心律不齐2例,S-T段及T波改变2例。感染性贫血1例,恶心、呕吐13例,腹痛8例,肝功能异常6例,皮疹2例,部分患者伴有胃肠道症状及局部表浅淋巴结肿大。X线检查:胸片提示斑片状或点状阴影,伴胸膜反应3例。心电图检查:33例正常,4例提示窦性心动过速,S-T段及T波改变2例,窦性心律不齐2例。结果:经过药物治疗,41例肺炎支原体感染患儿均临床治愈。结论:婴幼儿支原体肺炎临床表现不典型,肺外表现多,经合理治疗预后良好。

Objective：According to the clinical manifestations of the pediatric pneumonia mycoplasma infection and characteristics,to discuss the methods of diagnosis and treatment.Method：41 children with mycoplasma pneumoniae infection in our hospital from April 2011 to April 2014 were selected as the research objects,the clinical data were retrospectively analyzed.41 patients had different degree of cough,sputum.Including 29 cases with a history of fever,34 cases showed only a diminished or enlargement of lung breath sounds,no dry wet rale when seeing a doctor.Wet rale appeared after a week,9 cases with wheezing,decreased breath sounds in 1 case,mild chest pain in 5 cases,the lesion area percussion dullness in 3 cases, no positive signs in 4 cases.Extrapulmonary manifestations：4 cases were sinus tachycardia,sinus arrhythmia in 2 cases,S-T and T wave change in 2 cases.Infectious anemia in 1 case,13 cases of nausea,vomiting,abdominal pain in 8 cases,6 cases of abnormal liver function,skin rash in 2 cases, some patients with gastrointestinal symptoms and local superficial lymph node enlargement.X-ray suggests patchy shadows or dotted,3 cases with pleural reaction.Ecg examination：33 cases were normal,4 cases of sinus tachycardia,S–T segment and T wave change in 2 cases,sinus arrhythmia in 2 cases. Result：After drug treatment,41 cases were clinical cure.Conclusion：The clinical manifestations of infant and young child mycoplasma pneumonia is not typical,there are many extrapulmonary performance,after reasonable treatment,the prognosis is good.