1例儿童肺炎支原体肺炎合并肺栓塞临床分析

Clinical Analysis of One Child with Mycoplasma Pneumoniae Pneumonia Complicated with Pulmonary Embolism

目的:探讨肺炎支原体肺炎合并肺栓塞的临床表现、诊断和治疗要点。方法:回顾性分析1例肺炎支原体肺炎合并肺栓塞患儿的临床特征及诊疗经过。结果:患儿在抗感染治疗过程中出现了胸痛、咯血的症状,D-二聚体>20 mg/L,经检查明确存在肺栓塞,经抗感染、激素抑制炎性反应,低分子肝素钙、阿司匹林抗凝等治疗,患儿症状明显好转,复查D-二聚体降至1. 1 mg/L。随访复查胸CTA未见肺栓塞征象,肺内病变吸收。结论:肺炎支原体肺炎患儿在治疗过程中,如出现胸痛、咯血、D-二聚体升高,需注意肺栓塞的发生,早期诊断、积极抗凝治疗是诊治的关键。

Objective: To probe into the clinical manifestations,diagnosis and treatment of Mycoplasma pneumoniae pneumonia complicated with pulmonary embolism. Methods: Retrospective analysis was conducted on clinical characteristics and diagnosis and treatment of one child with Mycoplasma pneumoniae pneumonia complicated with pulmonary embolism. Results: During the anti-infection treatment,the child developed chest pain and hemoptysis. D-dimer was >20 mg/L. After examination,it was confirmed that there was pulmonary embolism,and after treatment with anti-infection,hormone suppression of inflammatory response,low molecular weight heparin calcium and aspirin anticoagulation,the symptoms of the child were improved significantly. And D-dimer decreased to 1. 1 mg/L.Follow-up review of chest CTA showed no signs of pulmonary embolism,and pulmonary lesions were absorbed. Conclusion: Pulmonary embolism may accompanied by chest pain,hemoptysis and D-dimer elevation in children with Mycoplasma pneumoniae pneumonia during treatment. Early diagnosis and actively anticoagulation treatment is the key to obtain better prognosis.