儿童重症肺炎支原体肺炎临床特征分析

Clinical Characteristics of Sever Pneumonia Mycoplasma Pneumoniae in Children

目的:分析儿童重症肺炎支原体肺炎(MPP)的临床特征,为临床诊治提供参考依据。方法:对我院2015年1月至2016年12月住院治疗的152例MPP患儿的临床资料进行回顾性分析。结果:重症组以学龄前期儿童为主,年龄较普通组小,两组年龄构成比较差异有统计学意义(P<0.05)。重症组发热、咳嗽及住院时间较普通组长(P<0.05),气急发生率、肺部体征阳性率、炎性指标增高比例均大于普通组(P<0.05)。有26例(48.1%)重症组患儿出现肺外并发症,以肝功能损害最常见。重症组激素和静脉丙种球蛋白使用率均大于普通组(P<0.05)。29例(53.7%)重症组患儿进行了电子支气管镜肺泡灌洗术。两组患儿治疗有效率比较差异无统计学意义(P>0.05)。结论:肺炎支原体感染后小龄儿童更易发展为重症MPP,重症MPP临床症状重,肺部炎症明显,易合并肺内外并发症,经抗感染、免疫支持、支气管镜肺泡灌洗术治疗,预后良好。

Objective： To investigate clinical characteristics of sever Mycoplasma Pneumoniae pneumonia（ MPP） in children and provide clinical basis for diagnosis and treatments. Methods： Clinical data of 152 cases of children with MPP treated in our hospital from January 2015 to December 2016 were collected and retrospectively analyzed. Results： The severe group was mainly preschool children,and there was a statistically significant difference in the age composition ratio between the severe group and the common group（ P 〈0. 05）. The time of fever,cough and hospital stay in the severe group were significantly longer than those in the common group（ P 〈0. 05）. The incidence rate of shortness of breath,the positive rate of pulmonary signs and the rate of increasing of inflammatory indexes in the severe group were significant higher than those in the common group（ P〈0. 05）. Twenty-six cases（ 48. 1%） of the severe group were with extra-pulmonary complications,and liver function damage was the most common. The rates of using hormone and intravenous gamma globulin were significantly higher in the severe group than those in the common group（ P〈0. 05）. Twenty-nine cases（ 53. 7%）of the severe group underwent alveolar lavage by electronic bronchoscopy. There was no significant difference in the efficiency of treatment between the two groups（ P〉 0. 05）. Conclusion： Younger children are more likely to develop sever MPP after Mycoplasma Pneumoniae infection. Sever MPP are always with serious clinical symptoms,obvious pulmonary inflammation,intra-/extra-pulmonary complications,and good prognosis after anti-infection,immune support and alveolar lavage by electronic bronchoscopy.