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目的探讨小儿重症支原体肺炎(MPP)的临床特点、影像学特点、常见并发症以及诊治经验。方法分析56例重症支原体肺炎患儿临床特征、诊治过程,并结合文献进行讨论。结果 56例患儿均有发热、咳嗽表现,合并胸腔积液10例,肺不张16例;合并川崎病2例;合并传染性单核细胞增多症6例,所有患儿均有不同程度肺外病灶。结论肺炎支原体可引起重症肺炎,肺外症状多见心肌、肝功能受损、神经系统受损。对于临床上有上述表现的重症肺炎,应考虑到MPP的可能性。根据发病机制,对重症支原体肺炎患儿除应用大环内酯类抗生素外,及时联合使用肾上腺皮质激素和丙种球蛋白治疗,预后大多良好。
Objective To investigate the clinical features, imaging features, common complications and diagnosis and treatment of pediatric severe mycoplasma pneumonia (MPP). Methods 56 cases of severe Mycoplasma pneumonia in children with clinical features, diagnosis and treatment process, combined with the literature to discuss. Results 56 cases of children with fever, cough, pleural effusion in 10 cases, atelectasis in 16 cases; Kawasaki disease in 2 cases; combined infectious mononucleosis in 6 cases, all children have different degrees of lung Outside the lesion. Conclusions Mycoplasma pneumoniae can cause severe pneumonia. Myocardial extrahepatic symptoms are more common, impaired liver function and impaired nervous system. For the clinical manifestations of severe pneumonia, the possibility of MPP should be considered. According to the pathogenesis of severe mycoplasma pneumonia in children in addition to macrolide antibiotics, the timely combination of corticosteroids and gamma globulin treatment, the prognosis are mostly good.