儿童坏死性肺炎诊治进展

Progress in the diagnosis and treatment of necrotizing pneumonia in children

坏死性肺炎是社区获得性肺炎中一种罕见却严重的并发症,是病原微生物与机体免疫紊乱共同作用的结果,近年来发病率逐渐升高。坏死性肺炎以肺实质结构破坏、液化坏死形成空洞为特征,各种病原体感染均可导致儿童坏死性肺炎。国外报道以肺炎链球菌和金黄色葡萄球菌为主要病原,我国则可能以肺炎支原体为主。儿童坏死性肺炎较普通肺炎病情严重、进展迅速,病程长且并发症多,其诊断有赖于胸部CT。在抗生素治疗的基础上,联合糖皮质激素、丙种球蛋白以及支气管肺泡灌洗等,大部分患儿预后良好。

Necrotizing pneumonia is a rare but serious complication of community-acquired pneumonia.It is the result of the joint action of pathogenic microorganism and immune disorder.The incidence rate increased gradually in recent years.Necrotizing pneumonia is characterized by the destruction of the parenchyma structure of the lung and the formation of cavity in the liquefied necrosis,and the infection of various pathogens can lead to necrotic pneumonia in children.The main reponsible bacteria are Streptococcus pneumoniae and Staphylococcus aureus in foreign reports,and are Mycoplasma pneumoniae in our country.The necrotizing pneumonia in children is more severe and progresses more rapid,has longer course and more complications than common pneumonia.The diagnosis depends on the CT.In addition of antibiotic treatment,combination of glucocorticoid,gamma globulin and bronchoalveolar lavage was used,and most of the children have good prognosis.