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目的了解江苏地区儿童重症肺炎支原体肺炎的临床特征,以提高早期诊断及治疗水平。方法收集2010年7月至2013年4月在本科确诊为重症肺炎支原体肺炎的住院患儿105例,采用酶联免疫吸附法(ELISA)检测MP-IgM抗体,回顾性分析患儿的临床表现、治疗转归等。结果重症肺炎支原体肺炎多以高热伴痉挛性咳嗽为临床主诉,肺部可闻及干、湿罗音68例(64.8%);胸部影像学检查提示肺内病变多累及单侧或双侧肺,易合并胸腔积液及肺不张;单纯大环内酯类抗生素治疗效果欠佳,需联合头孢三代抗生素治疗,部分病例需加用激素和(或)静脉丙种球蛋白;所有患儿预后均良好。结论重症肺炎支原体肺炎病情重、进展快,可引起肺内、外并发症且病情迁延。早期识别、早期积极治疗,大多患者预后良好。
Objective To understand the clinical features of children with severe pneumonia mycoplasma pneumonia in Jiangsu Province in order to improve the level of early diagnosis and treatment. Methods A total of 105 hospitalized children with mycoplasma pneumoniae pneumonia were identified from July 2010 to April 2013 in our hospital. MP-IgM antibody was detected by enzyme-linked immunosorbent assay (ELISA). The clinical manifestations, Treatment outcome and so on. The results of severe Mycoplasma pneumoniae pneumonia and fever with spasmodic cough are the main clinical complaints, the lung can be heard and dry and wet rales in 68 cases (64.8%); chest imaging examination showed that more lesions involving the lungs unilateral or bilateral lung, Easy to merge pleural effusion and atelectasis; simple macrolide antibiotics ineffective treatment, combined with three generations of antibiotics cephalosporin treatment, in some cases need to add hormones and (or) intravenous gamma globulin; all children with good prognosis . Conclusions Severe Mycoplasma pneumoniae pneumonia is seriously ill and progresses rapidly. It can cause pulmonary complications and prolong the disease. Early identification, early active treatment, most patients with good prognosis.