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目的探讨儿童重症肺炎支原体肺炎(MPP)的临床特点及预后。方法选取本院2010年1月~2013年6月105例重症MPP患儿(重症组),并选取同时期105例轻症MPP患儿作为对照组,分析比较两组临床特点及治疗预后情况。结果重症MPP大部分临床症状有咳嗽、高热,高热持续时间长,极易有气促、心动过速现象,有的还会出现发绀、三凹征症状,经肺部影像学检测一般会显示大片状阴影,伴或不伴肺不张症状、胸腔积液、坏死性肺炎等肺内严重并发症,还有的患者出现呼吸系统、神经系统、循环系统、消化系统、泌尿系统等均出现功能受损现象。重症MPP患者中有16例发生闭塞性支气管炎症状。17例重症患儿随访只有4例基本好转,肺功能恢复正常;其余经肺部高分辨CT检查有肺不张现象。结论临床症状严重、发热持续时间长、肺部影像学呈现大片状阴影,合并肺不张等肺内严重并发症患者或存在系统功能受损严重MPP患儿,需予以高度关注并及早予以治疗,若重症MPP患者出现遗留性肺结构及功能受损现象,需予以肺部高分辨CT检查并长期随访。
Objective To investigate the clinical features and prognosis of children with severe Mycoplasma pneumoniae pneumonia (MPP). Methods A total of 105 severe MPP children (severe group) from January 2010 to June 2013 in our hospital were selected. 105 children with mild MPP in the same period were selected as the control group. The clinical features and prognosis of the two groups were analyzed and compared. Results Most of severe clinical symptoms of MPP have cough, fever, hyperthermia, long duration, very easy to have shortness of breath, tachycardia phenomenon, and some will appear cyanosis, three depression symptoms, the lung imaging tests generally show large Flake shadow, with or without atelectasis symptoms, pleural effusion, necrotizing pneumonia and other serious complications in the lungs, and some patients appear respiratory system, nervous system, circulatory system, digestive system, urinary system, etc. all appear Damaged. 16 cases of severe MPP patients with occlusive bronchitis symptoms. Only 17 of the 17 critically ill children were followed up for only 4 cases. The lung function returned to normal. The rest of the cases were diagnosed as pulmonary atelectasis by high resolution pulmonary CT. Conclusions Patients with severe clinical symptoms, long duration of fever, large lung shadow radiographs, severe intrapulmonary complications such as atelectasis, or severe MPP with impaired system function need to be given high attention and treated as soon as possible , If severe MPP patients with residual lung structure and impaired function, need to be high-resolution lung CT examination and long-term follow-up.