CAJ | 학술논문

　　目的探讨和分析临床上胸片成大叶性肺炎改变的儿童肺炎支原体肺炎患者的特点，并总结对其治疗的经验。方法我院在2010年1月～2013年3月期间，来我院就诊的儿童肺炎患者有818例，患者表现为胸片呈大叶性肺炎改变和血肺炎支原体抗体阳性。对患者的临床资料进行回顾性分析和总结。结果其中中学龄以上的发病患者有446例，占54．5％；在婴幼儿期发病的患者有190例，占23．2％。患者的病程长，主要以发热为主要症状，对患者进行胸片检查，其中有718例患者出现单侧病变，占87．8％；450例患者出现合并肺外并发症，占55．1％；650例患者的外周血常规中，白细胞计数要比正常高，占79．4％；518例患者的中性粒细胞比例在0．80以上，占63．3％；患者的单核细胞比例在0．08以上，占77．5％；有648例患者的超敏C反应蛋白比正常要高，占83．7％。对患者的体液进行培养，一共培养出324株阳性菌株，然而最为常见的合并细菌有：金黄色葡萄球菌和肺炎链球菌。对这些合并类的细菌感染患者采用大环内酯类药物进行治疗，效果不佳，但是联合青霉素进行治疗之后，效果明显。结论对肺炎支原体胸片改变的多样要值得引起重视。然而，对于对于胸片成大叶性肺炎的改变，只是对其使用单纯的大环内酯类抗生素进行治疗。目前的效果并不理想。因此，在对其进行治疗时，要注意患者发生合并性的细菌感染。应该先对患者进行病原体的检查之后，再对患者采用联合用药的方式进行治疗。
　　목적탐토화분석림상상흉편성대협성폐염개변적인동폐염지원체폐염환자적특점，병총결대기치료적경험。방법아원재2010년1월～2013년3월기간，래아원취진적인동폐염환자유818례，환자표현위흉편정대협성폐염개변화혈폐염지원체항체양성。대환자적림상자료진행회고성분석화총결。결과기중중학령이상적발병환자유446례，점54．5％；재영유인기발병적환자유190례，점23．2％。환자적병정장，주요이발열위주요증상，대환자진행흉편검사，기중유718례환자출현단측병변，점87．8％；450례환자출현합병폐외병발증，점55．1％；650례환자적외주혈상규중，백세포계수요비정상고，점79．4％；518례환자적중성립세포비례재0．80이상，점63．3％；환자적단핵세포비례재0．08이상，점77．5％；유648례환자적초민C반응단백비정상요고，점83．7％。대환자적체액진행배양，일공배양출324주양성균주，연이최위상견적합병세균유：금황색포도구균화폐염련구균。대저사합병류적세균감염환자채용대배내지류약물진행치료，효과불가，단시연합청매소진행치료지후，효과명현。결론대폐염지원체흉편개변적다양요치득인기중시。연이，대우대우흉편성대협성폐염적개변，지시대기사용단순적대배내지류항생소진행치료。목전적효과병불이상。인차，재대기진행치료시，요주의환자발생합병성적세균감염。응해선대환자진행병원체적검사지후，재대환자채용연합용약적방식진행치료。
objective to investigate and analysis the clinical X -ray change into lobar pneumonia mycoplasma pneumoniae pneumonia in children of the characteristics of the patients ,and summarize the experience of treatment .Methods in our hospital from January 2010 to March 2010 ,during the period of childhood pneumonia patients to our hospital in 818 patients ,patients show the chest radiograph is lobar pneumonia mycoplasma pneumoniae antibody positive changes and blood .The clinical data of patients were retrospectively analyzed and sum-marized .Results among them more than school age in the onset of patients with 446 cases ,accounting for 54 .5% ;In the infant stage pa-tients with 190 cases of the disease ,accounting for 23 .2% .Progression in patients with long ,mainly is main symptom with fever ,chest X-ray examination was performed ,including 718 cases of patients with unilateral lesions ,accounted for 87 .8% ;450 cases of patients with pulmonary complications ,accounting for 55 .1% ;650 patients peripheral blood routine ,w hite blood cell count is higher than normal ,ac-counted for 79 .4% ;518 patients of neutrophils ratio above 0 .80 ,accounted for 63 .3% ;Mononuclear cells in patients with ratio above 0 .08 , accounting for 77 .5% ;In 648 patients hypersensitive c -reactive protein in patients with higher than normal ,accounted for 83 .7% .Body fluids of patients develop ,cultivate a total of 324 strains of positive strains ,however ,the most common with bacteria :staphylococcus aureus and streptococcus pneumoniae .For these combined bacterial infections were treated by large ring lactone class drug treatment ,the effect not beautiful ,but the joint after treatment with penicillin ,effect is obvious .Conclusion for mycoplasma pneumoniae X -ray change of diversity to worthy of attention .However ,for the X -ray into the change of the lobar pneumonia ,just pure of the large ring lactone class antibiotic treatment .The effect is not ideal .Therefore ,in carries on the treatment ,pay attention to the combination in patients with bacterial infec-tion .Should after the pathogen examination was performed first ,then adopt the way of combination treatment of patients .