溶栓治疗儿童肺炎支原体肺炎并心腔血栓及肺栓塞2例

Thrombolytic therapy for 2 children with Mycoplasma pneumoniae pneumonia complicated with intracardiac thrombosis and pulmonary embolism

对2019年7月至2020年1月天津市儿童医院收治的2例难治性肺炎支原体肺炎并心腔血栓及肺栓塞患儿的临床资料进行回顾性分析。例1, 女, 8岁, 主因"发热5 d、咳嗽2 d"入院。例2, 男, 7岁, 主因"间断发热伴咳嗽24 d, 胸痛1 d"入院。2例患儿D-二聚体水平均升高, 且抗磷脂抗体均为阳性, 治疗过程中出现右心血栓及肺栓塞, 血栓相关症状表现均不典型。经抗凝及尿激酶溶栓治疗, 心腔血栓最终消散, 肺栓塞好转。针对难治性肺炎支原体肺炎并心腔血栓及肺栓塞, 除抗凝治疗外, 部分患儿可考虑溶栓治疗。

The clinical data of 2 children with refractory Mycoplasma pneumoniae pneumonia complicated with intracardiac thrombosis and pulmonary embolism,treated in Tianjin Children′s Hospital from July 2019 to January 2020,were analyzed retrospectively.One patient was an 8-year-old girl,who was admitted to the hospital mainly because of"fever for 5 days and cough for 2 days".The other patient was a 7-year-old boy,who was admitted due to"intermittent fever with cough for 24 days and chest pain for 1 day".Both children were complicated with elevated D-dimer levels and positive antiphospholipid antibody.During the treatment,right cardiac thrombosis and pulmonary embolism occurred in both cases,and the manifestations of thrombosis related symptoms were not typical.After the patients received anticoagulation treatment and thrombolytic therapy with urokinase,the cardiac thrombus dissipated and the pulmonary embolism improved.For refractory Mycoplasma pneumoniae pneumonia complicated with intracardiac thrombosis and pulmonary embolism,thrombolytic therapy can be applied to some children in addition to anticoagulant therapy.