中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2013年
13期
3-6
,共4页
儿童%社区获得性肺炎%肺炎支原体
兒童%社區穫得性肺炎%肺炎支原體
인동%사구획득성폐염%폐염지원체
Children%Community acquired pneumonia%Mycoplasma pneumoniae pneumonia
目的 探讨儿童社区获得性肺炎支原体肺炎的临床特点.方法 总结分析180例社区获得性肺炎支原体肺炎患儿的临床表现、胸部X线特点、外周血白细胞计数、MP-IgM抗体检测、治疗等临床资料.结果 儿童肺炎支原体肺炎(MPP)临床表现为中高热、刺激性干咳、喘息.60例(33.33％)患儿病程中出现喘息,5岁以下儿童较易出现喘息.肺部体征主要表现为湿哆音、哮鸣音.5岁以上儿童的肺部体征主要表现为单侧湿啰音,5岁以下儿童的肺部体征主要表现为哮鸣音.本研究显示MPP肺外表现主要为皮疹、呕吐、腹泻、心电图改变.胸部X线病变类型以小叶实质浸润性病变为主,123例(68.33％)累及双肺,3岁以下婴幼儿易累及双肺.57例(31.67％)单侧肺部受累,其中40例(22.22％,多为5岁以上儿童)右中下肺受累.78例(43.33％,多为5岁以下儿童)儿童外周血白细胞计数在正常范围,5岁以上儿童血常规的特点以白细胞计数偏高为主.68例(37.78％)1周内检测血清MP-IgM水平不高,需要进行双份血清抗体检测来诊断.所有患儿均使用阿奇霉素序贯疗法,总疗程不少于3周.所有患儿经治疗均临床治愈.结论 肺炎支原体已成为儿童社区获得性肺炎的重要致病原,不同年龄组儿童临床表现不一致.对于首次喘息发作的患儿或反复喘息发作的患儿要充分考虑肺炎支原体感染的可能,尽早明确诊断,充分治疗,防止发展为哮喘.
目的 探討兒童社區穫得性肺炎支原體肺炎的臨床特點.方法 總結分析180例社區穫得性肺炎支原體肺炎患兒的臨床錶現、胸部X線特點、外週血白細胞計數、MP-IgM抗體檢測、治療等臨床資料.結果 兒童肺炎支原體肺炎(MPP)臨床錶現為中高熱、刺激性榦咳、喘息.60例(33.33％)患兒病程中齣現喘息,5歲以下兒童較易齣現喘息.肺部體徵主要錶現為濕哆音、哮鳴音.5歲以上兒童的肺部體徵主要錶現為單側濕啰音,5歲以下兒童的肺部體徵主要錶現為哮鳴音.本研究顯示MPP肺外錶現主要為皮疹、嘔吐、腹瀉、心電圖改變.胸部X線病變類型以小葉實質浸潤性病變為主,123例(68.33％)纍及雙肺,3歲以下嬰幼兒易纍及雙肺.57例(31.67％)單側肺部受纍,其中40例(22.22％,多為5歲以上兒童)右中下肺受纍.78例(43.33％,多為5歲以下兒童)兒童外週血白細胞計數在正常範圍,5歲以上兒童血常規的特點以白細胞計數偏高為主.68例(37.78％)1週內檢測血清MP-IgM水平不高,需要進行雙份血清抗體檢測來診斷.所有患兒均使用阿奇黴素序貫療法,總療程不少于3週.所有患兒經治療均臨床治愈.結論 肺炎支原體已成為兒童社區穫得性肺炎的重要緻病原,不同年齡組兒童臨床錶現不一緻.對于首次喘息髮作的患兒或反複喘息髮作的患兒要充分攷慮肺炎支原體感染的可能,儘早明確診斷,充分治療,防止髮展為哮喘.
목적 탐토인동사구획득성폐염지원체폐염적림상특점.방법 총결분석180례사구획득성폐염지원체폐염환인적림상표현、흉부X선특점、외주혈백세포계수、MP-IgM항체검측、치료등림상자료.결과 인동폐염지원체폐염(MPP)림상표현위중고열、자격성간해、천식.60례(33.33％)환인병정중출현천식,5세이하인동교역출현천식.폐부체정주요표현위습치음、효명음.5세이상인동적폐부체정주요표현위단측습라음,5세이하인동적폐부체정주요표현위효명음.본연구현시MPP폐외표현주요위피진、구토、복사、심전도개변.흉부X선병변류형이소협실질침윤성병변위주,123례(68.33％)루급쌍폐,3세이하영유인역루급쌍폐.57례(31.67％)단측폐부수루,기중40례(22.22％,다위5세이상인동)우중하폐수루.78례(43.33％,다위5세이하인동)인동외주혈백세포계수재정상범위,5세이상인동혈상규적특점이백세포계수편고위주.68례(37.78％)1주내검측혈청MP-IgM수평불고,수요진행쌍빈혈청항체검측래진단.소유환인균사용아기매소서관요법,총료정불소우3주.소유환인경치료균림상치유.결론 폐염지원체이성위인동사구획득성폐염적중요치병원,불동년령조인동림상표현불일치.대우수차천식발작적환인혹반복천식발작적환인요충분고필폐염지원체감염적가능,진조명학진단,충분치료,방지발전위효천.
Objective To investigate the clinical features of community acquired mycoplasma pneumoniae pneumonia(MPP) in children.Methods The clinical data including clinical manifestations,chest X-ray features,WBC count,serium MP-IgM antibody levels and treatment effects of 180 children with MPP were analyzed.Results The common clinical manifestations of MPP were high fever,irritating cough and wheezing.Sixty cases (33.33％) appeared wheezing,under 5 years old children were prone to wheezing.Moist rales and expiratory wheeze were heared on chest auscultation.Unilateral moist rales were the main features of lung auscultation for children above 5 years old.Wheezing were the main pulmonary signs for under 5 years age children.The MPP extrapulmonary manifestations were rash,vomiting,diarrhea and ECG changes.The predominant chest X-ray lesion type was lobular parenchymal infiltration,both lungs involved in 123 cases(68.33％),most of them were under 3 years old infants and young children.Unilateral lung lesion in 57 cases (31.67％),right middle and lower lung zone lesion in 40 cases (22.22％),most of them were over 5 years old.WBC count was in the normal ranges in 78 patients (43.33％),most of them were under 5 years old.WBC count was high in children over 5 years old.Serum MP-IgM level was lower within 1 week of 68 cases(37.78％),but double serum antibody was needed to diagnose.All patients were treated with sequential therapy of azithromycin.The total course was not less than 3 weeks.After treatment,all patients were clinically cured.Conclusions Mycoplasmapneumoniae has become an important pathogen of community acquired pneumonia in children.The clinical manifestation of childrens of different age groups are inconsistent.When the first wheezing and recurrent wheezing occured in children,full consideration to the posibility of MP infection should be given.To prevent the development of asthma,the early diagnosis and the adequate treatment were needed.
