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目的探讨儿童大叶性肺炎的临床特点。方法对2007年1月至2013年5月诊治的102例儿童大叶性肺炎患儿的临床症状、体征、影像学X线或CT特点进行回顾性分析。结果 102例患儿中发热100例,咳嗽99例,胸痛19例;发病最短2 d,最长10 d;病原学检查提示支原体血清IgM阳性45例,白细胞计数>10×109/L 49例,C-反应蛋白>40 mg/L 26例,混合感染61例,肝及心肌损害82例(心肌损害73例,肝损害19例)。经系统性治疗后治愈89例,好转11例,转上级医院2例,无死亡病例。结论对于持续发热≥3 d,伴咳嗽或持续高热原因不明的年长儿应早期影像学检查及加强病原学检查,应及时诊断,针对性用药、抗生素足量、联合、疗程应用,密切接触者可能会传染,合并胸膜炎、胸腔积液及有全身中毒症状者可予激素减轻炎症反应。
Objective To investigate the clinical features of lobar pneumonia in children. Methods The clinical features, signs, imaging X-ray or CT features of 102 cases of children with lobule pneumonia diagnosed and treated from January 2007 to May 2013 were analyzed retrospectively. Results 102 cases of children with fever in 100 cases, 99 cases of cough, chest pain in 19 cases; onset of the shortest 2 d, up to 10 days; etiological examination prompted mycoplasma serum IgM positive in 45 cases, white blood cell count> 10 × 109 / L in 49 cases, C-reactive protein> 40 mg / L in 26 cases, mixed infection in 61 cases, liver and myocardial damage in 82 cases (myocardial damage in 73 cases, liver damage in 19 cases). After systemic treatment, 89 cases were cured, improved in 11 cases, transferred to superior hospital in 2 cases, no deaths. Conclusions For older children who have persistent fever> = 3 d and who have unexplained cough or persistent high fever, they should be diagnosed early by timely imaging examination and etiological examination should be timely diagnosis, targeted medication, adequate antibiotics, combination therapy, close contact May be contagious, pleurisy, pleural effusion and symptoms of systemic poisoning may be hormone to reduce inflammation.