肺炎支原体塑型性支气管炎5例临床分析

Clinical analysis of Mycoplasma pneumoniae plastic bronchitis in 5 children

目的分析肺炎支原体塑型性支气管炎临床特点。方法回顾分析5例肺炎支原体塑型性支气管炎患儿的临床资料。结果 5例患儿,男4例、女1例,均有咳嗽、高热,热程为5～13天;呼吸困难、呼吸衰竭3例;合并中毒性肝炎2例,中毒性脑病、中毒性心肌炎各1例,髂静脉及股静脉血栓1例。胸部影像学检查5例均有单侧肺不张伴肺实变。病程第4～10天经支气管镜检查见塑型物堵塞段支气管4例、主支气管1例,确诊为塑型性支气管炎,经2～4次支气管镜术钳取出塑型物,临床治愈出院。结论肺炎支原体肺炎伴呼吸困难、单侧肺不张/肺实变,需警惕塑型性支气管炎;支气管镜术对明确诊断、改善预后有重要作用。

Objective To analyze the clinical characteristics of Mycoplasma pneumoniae plastic bronchitis. MethodThe clinical data of Mycoplasma pneumoniae plastic bronchitis in 5 children were retrospectively analyzed. ResultsFive children (4 boys and 1 girl) all had cough and high fever and the fever duration was 5~13 days. Dyspnea and respiratory failure were found in 3 children, toxic hepatitis in 2 children, toxic encephalopathy in 1 child, toxic myocarditis in 1 child, and iliac vein and femoral vein thrombosis in 1 child. Chest imaging examination showed unilateral atelectasis with pulmonary consolidation in 5 children. Plastic bronchitis was confirmed on the 4th to 10th day of the disease course by bronchoscopy. 4 patients had bronchial obstruction and 1 patient had main bronchus obstruction. The plastic body was removed completely by bronchoscopy for 2-4 times. The children were cured clinically and discharged. ConclusionPlastic bronchitis should be considered in children with Mycoplasma pneumoniae pneumonia combined with dyspnea, unilateral atelectasis/consolidation. Bronchoscopy plays an important role in confirming diagnosis and improving prognosis.