20例儿童难治性支原体肺炎临床分析

Clinical analysis on 20 cases of refractory Mycoplasma pneumoniae

目的探讨难治性支原体性肺炎(RMPP)的临床特点,诊断依据和治疗方法。方法收集2013年6月至2014年5月在天津市儿童医院住院的20例RMPP患儿的临床资料,汇总血常规、C反应蛋白、肺CT、支原体抗体及DNA、血沉等临床数据进行分析。结果 20例患者均出现高热不退,并逐渐出现肺部实变体征,部分患者并发肝功能损伤,皮疹,血液系统损伤等肺外表现。早期加用激素疗效肯定。纤维支气管镜对缓解气道阻塞效果良好。结论 RMPP发病年龄较大,容易合并其他系统损伤,早期诊断尤为重要。激素及纤维支气管镜疗效肯定。应采取综合治疗。

Objective To investigate clinical characteristics, diagnostic basis and treatment of Mycoplasma pneumoniae （RMP）. Methods The clinical data of 20 hospitalized children diagnosed as RMP during June 2013 and May 2014 at Tianjin Children＇s Hospital were collected, including blood RT, MP-IgM, MP-DNA and pulmonary CT etc. , and were analyzed. Results All the patients suffered from persistent high fever with positive sign of lung consolidation along with the development of the disease. Complications such as impairment of liver function, rash and blood system damage developed in a few patients. Early hormone therapy was effective. Bronehofibroscope resulted in a satisfactory resmission of airway obstruction. Combination of multi-treatment approaches was the key to cure RMP. Conclusion RMP with older age of onset tends to complicate with injury of other systems. Early diagnosis is crucial for RMP. Hormone and Bronehofibroscope have positive effects. Muhimodality therapy is necessary.