CAJ | 학술논문

目的探讨重症支原体肺炎(MPP)患儿的临床特征、治疗方案和转归,以利早期识别重症支原体肺炎,并且把握治疗时机进行合理治疗.方法对10例重症支原体肺炎患儿的临床资料进行回顾性分析,并进行随诊.结果与轻症组相比,重症支原体肺炎患儿入院前发热天数、总发热天数明显增多,外周血白细胞总数及C-反应蛋白明显增高,血沉增快,IgM、IgE水平明显增高.10例重症支原体肺炎患儿中,急性期10例肺实变,6例合并中至大量胸腔积液,其中1例合并支原体脑炎.10例患儿治疗除应用抗生素外均加用糖皮质激素,疗效满意,恢复期2例患儿遗留闭塞性细支气管炎,1例遗留中枢神经系统后遗症.结论对于临床上有上述表现的重症肺炎患儿应考虑到MPP的可能性,治疗上除应用大环内酯类抗生素外,可加用利福平、糖皮质激素治疗.
목적 탐토중증지원체폐염(MPP)환인적림상특정、치료방안화전귀,이리조기식별중증지원체폐염,병차파악치료시궤진행합리치료.방법 대10례중증지원체폐염환인적림상자료진행회고성분석,병진행수진.결과 여경증조상비,중증지원체폐염환인입원전발열천수、총발열천수명현증다,외주혈백세포총수급C-반응단백명현증고,혈침증쾌,IgM、IgE수평명현증고.10례중증지원체폐염환인중,급성기10례폐실변,6례합병중지대량흉강적액,기중1례합병지원체뇌염.10례환인치료제응용항생소외균가용당피질격소,료효만의,회복기2례환인유류폐새성세지기관염,1례유류중추신경계통후유증.결론 대우림상상유상술표현적중증폐염환인응고필도MPP적가능성,치료상제응용대배내지류항생소외,가가용리복평、당피질격소치료.
Objective To study the clinical characteristics, therapeutic regimen and outcome of severe mycoplasma pneumonia (MP) in children.Methods Clinical data of 10 children with severe mycoplasma pneumonia were retrospectively analyzed and followed-up.Results In severe MP cases, the fever duration prior to hospitalization and the total fever duration were more prolonged, peripheral blood leucocytes counts, C-reactive protein and erythrocyte sedimentation rate increased, and serum IgM and IgE levels increased as compared to mild MP cases. Of the 10 cases of severe MP, 10 manifested as pulmonary consolidation, 6 as pulmonary consolidation complicated with moderate to large pleural effusion and with 1 of them complicated with central nervous systen mycoplasma infection. Ten severe MP cases were administered with glucocorticoid as well as antibiotics, and the therapeutic effect was satisfactory. In the convalescence stage, 2 cases were complicated with bronchiditis obliterans.Conclusions Severe MP is characterized by rapid progression, pulmonary consolidation, moderate to severe pleural effusion, obviously increased inflammatory indexes, and poor therapeutic reaction to simple macrolide antibiotics. Besides antibiotics,rifampin, glucocorticoid should be used for severe MP cases as soon as possible.