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目的探讨肺炎支原体(MP)所致大叶性肺炎的临床特点。方法对阜阳市人民医院2008年1月-2011年8月收治的46例MP所致大叶性肺炎患儿的临床资料进行回顾性分析。结果 MP所致的大叶性肺炎发病多见于学龄期儿童,临床表现为起病急,病程长,持续性高热不退,常为稽留热,阵发性剧烈咳嗽,具有肺部体征轻微,胸片表现重,病变多位于单侧肺,以右中下肺多见,可合并胸腔积液、肺不张等肺内并发症。且易合并肺外并发症及多脏器功能损害,早期易误诊。明确诊断后及时应用大环内酯类抗生素阿奇霉素治疗,合并全身炎症反应综合征应用小剂量肾上腺皮质激素治疗。本组病例45例(除1例转诊外)经治疗2～4个疗程全部治愈。结论掌握MP所致大叶性肺炎的临床特征,尽可能做到早期诊断,早期治疗,使用大环内酯类抗生素阿奇霉素治疗,及时应用小剂量肾上腺皮质激素和静脉丙种球蛋白治疗,提高治愈率,减少后遗症的发生。
Objective To investigate the clinical features of lobar pneumonia caused by Mycoplasma pneumoniae (MP). Methods Retrospective analysis was performed on the clinical data of 46 cases of lobar pneumonia caused by MP in the People’s Hospital of Fuyang from January 2008 to August 2011. Results The incidence of MP-induced lobar pneumonia more common in school-aged children, the clinical manifestations of acute onset, long duration, persistent high fever, often as persistent fever, paroxysmal severe cough, with mild lung symptoms, chest Film performance, lesions are located in the unilateral lung, more common in the right middle and lower lung, pleural effusion may be combined, pulmonary atelectasis and other complications of the lungs. And easy to merge with pulmonary complications and multiple organ dysfunction, early misdiagnosis. A clear diagnosis of timely application of macrolide antibiotics azithromycin treatment, combined systemic inflammatory response syndrome with low-dose corticosteroid therapy. The group of 45 patients (except one referral) after treatment 2 to 4 courses of treatment were all cured. Conclusion To master the clinical features of MP caused by MP, to make early diagnosis and early treatment as possible, to use macrolide antibiotics azithromycin treatment, timely application of small doses of adrenocorticotropic hormone and intravenous gamma globulin treatment to improve the cure rate , Reduce the occurrence of sequelae.