三种序贯疗法治疗小儿肺炎支原体肺炎的效果

Effect of three sequential therapy on children with Mycoplasma pneumoniae pneumonia

目的探讨红霉素、阿奇霉素及红霉素联合阿奇霉素三种序贯疗法治疗小儿肺炎支原体肺炎的效果。方法回顾性分析2017年10月~2019年7月陆军第七十一集团军医院收治的150例肺炎支原体肺炎患儿的临床资料,根据用药方案将其分为红霉素序贯疗法(HMS)组、阿奇霉素序贯疗法(AQMS)组、红霉素-阿奇霉素序贯疗法(HMS-AQMS)组,每组50例。HMS组患儿静脉滴注红霉素7 d后改为口服红霉素3 d;AQMS组静脉滴注阿奇霉素5 d后停药3 d,之后改为口服阿奇霉素5 d;HMS-AQMS组静脉滴注红霉素7 d后改口服阿奇霉素3 d。比较三组患儿症状、体征、X线检查变化情况、临床疗效及不良反应发生情况。结果三组患儿的退热时间、咳嗽消失时间、肺部啰音消失时间及X线检查恢复正常时间比较,差异均无统计学意义(P>0.05)。HMS-AQMS组的总有效率为96.0%,高于HMS组(86.0%)和AQMS组(88.0%),差异有统计学意义(P<0.05)。三组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论红霉素-阿奇霉素续贯疗法治疗小儿肺炎支原体肺炎疗效更好,不良反应较低,因此在临床实践中值得推广与应用。

Objective To explore the effect of three sequential therapies consisting of Erythromycin,Azithromycin and Erythromycin combined with Azithromycin in the treatment of Mycoplasma pneumoniae pneumonia in children.Methods Retrospectively analyzed the clinical data of 150 children with Mycoplasma pneumoniae pneumonia admitted to the PLA 71st Army Group Hospital from October 2017 to July 2019.According to the medication plan,they were divided into the Erythromycin sequential therapy(HMS)group,the Azithromycin sequential therapy(AQMS)group and the Erythromycin-Azithromycin sequential therapy(HMS-AQMS)group,with 50 cases in each group.In HMS group,Erythromycin was given orally for 3 d after 7 d of intravenous drip.In AQMS group,Azithromycin was given intravenously for 5 d and stopped for 3 d,then orally for 5 d.In HMS-AQMS group,Erythromycin was given intravenously for 7 d and then Azithromycin was given orally for 3 d.The symptoms,signs,X-ray changes,clinical efficacy and adverse reactions of the three groups were compared.Results There were no significant differences in the time of fever abatement,cough disappearance,pulmonary rales disappearance and X-ray examination recovery time among the three groups(P>0.05).The total effective rate of HMS-AQMS group was 96.0%,which was higher than that of HMS group(86.0%)and AQMS group(88.0%),the difference was statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions among the three groups(P>0.05).Conclusion Erythromycin-Azithromycin continuous therapy in the treatment of children with Mycoplasma pneumoniae pneumonia has better curative effect and lower adverse reactions,so it is worthy of promotion and application in clinical practice.