阿奇霉素联合甲基强的松龙治疗儿童难治性支原体肺炎的疗效观察

Clinical efficacy observation of azithromycin combined with methylprednisolone in the treatment of refractory mycoplasma pneumonia in children

目的 对儿童难治性支原体肺炎临床特征及治疗方法进行分析.方法 选取2014年2月至2016年12月我院收治的难治性支原体肺炎的小儿患者90例,将其作为研究对象随机分为A、B两组,对两组患者分别采取阿奇霉素（A组）和阿奇霉素＋甲基强的松龙（B组）进行治疗.治疗结束后对两组患者的不良反应发生率、总有效率、退烧时间、咳嗽好转时间等进行对比评价.结果B组患儿的治疗总有效率为93.33%,高于A组的77.78%（P〈0.05）.B组患儿的退烧时间、咳嗽好转时间与A组相比,差异均无统计学意义（P〉0.05）.B组患儿不良反应的发生率为20.00%,与A组患儿不良反应发生率的17.78%比较,差异无统计学意义（P〉0.05）.此外,治疗后,两组患儿PO2、PCO2及WBC指标明显优于治疗前,且B组患儿的PO2、PCO2及WBC指标明显优于A组,差异均有统计学意义（P〈0.05）.结论 在难治性支原体肺炎的治疗中,阿奇霉素＋甲基强的松龙的治疗方案能够获得更好的治疗效果,未发生药物联用引起的其他不良反应,值得在临床上推广使用.

Objective To analyze the clinical characteristics and treatment efficacy of refractory mycoplasma pneumonia in children. Methods Ninety cases of pediatric children with refractory mycoplasma pneumonia treated in our hospital from February 2014 to December 2016 were selected as the study subjects and randomly divided into group A （treated with azithromycin） and group B （treated with azithromycin combined with methylprednisolone） according to the different treatment methods. After the treatment, the incidence of adverse reactions, total effective rate, fever time and cough time were compared between the two groups. Results Through comparing the prognosis of the disease, the total effective rate in group B was 93.33%, which was significantly higher than 77.78% of group A （P〈0.05）. The time of fever and cough relieving, and adverse reactions between the two groups were not statistically significant （P〉0.05）. Moreover, the level of PO2, PCO2 and WBC in the two groups after the treatment were all significantly superior to those before the treatment, and these indexes in group B were significantly superior to group A after the treatment （P〈0.05）. Conclusion In the treatment of refractory myeoplasma pneumonia, azithromyein combined with methylprednisolone could reach more excellent therapeutic efficacy, without other adverse reactions, which is worthy of clinical popularization.