儿童重症肺炎支原体肺炎40例临床分析

Clinical analysis of 40 children with severe mycoplasma pneumonia

目的探讨儿童重症肺炎支原体肺炎(MPP)的临床特征及治疗,提高诊治水平。方法对本院2016年1月~2017年12月间确诊的40例重症MPP患儿的临床特征和治疗效果进行回顾性分析。结果在40例重症肺炎支原体肺炎患儿中,所有患儿均有发热、咳嗽,气促5例,胸痛5例,肺部有阳性体征25例。所有患儿均有肺部X线平片和CT异常,胸腔积液4例,肺不张20例,肺实变12例,右肺下叶支气管扩张合并感染2例。15例白细胞计数升高,23例C反应蛋白升高,32例患儿行纤维支气管镜肺泡灌洗术。住院时间6~22 d,平均(12.82±5.44)d。结论儿童MPP可发展成重症肺炎,大环内酯类药物联合应用糖皮质激素、纤维支气管镜冲洗治疗,临床治疗效果显著。

Objective To investigate the clinical characteristics and treatment of severe mycoplasma pneumonia(MPP)in children and improve the diagnosis and treatment.Methods The clinical characteristics and therapeutic effects of 40 children with severe MPP diagnosed between January 2016 and December 2017 in our hospital were analyzed retrospectively.Results Among 40 children with severe pneumonia pneumoniae,all had fever and cough,and there were 5 cases of anhelation,5 cases of chest pain,and 25 cases of positive sign in lung.All patients had abnormalities in X-ray and CT,and there were 4 cases of pleural effusion,20 cases of pulmonary atelectasis,12 cases of pulmonary consolidation,and 2 cases of bronchiectasis in the inferior lobe of right lung.There were 15 cases of elevated leukocyte counts,and 23 cases of elevated C-reactive protein and 32 cases treated with bronchoalveolar lavage under fiber bronchoscope.The duration of hospitalization was 6 to 22 days,with an average of(12.82±5.44)days.Conclusion MPP can develop into severe pneumonia in children.Macrolides combined with glucocorticoids and bronchoalveolar lavage has significant clinical efficacy.