临床误诊误治
臨床誤診誤治
림상오진오치
CLINICAL MISDIAGNOSIS & MISTHERAPY
2015年
6期
1-3
,共3页
杨欣%李熙鸿%苏云洁%李亚飞%王静
楊訢%李熙鴻%囌雲潔%李亞飛%王靜
양흔%리희홍%소운길%리아비%왕정
肺炎支原体%心包积液%儿童%肺炎支原体IgM抗体%阿奇霉素
肺炎支原體%心包積液%兒童%肺炎支原體IgM抗體%阿奇黴素
폐염지원체%심포적액%인동%폐염지원체IgM항체%아기매소
Mycoplasma pneumoniae%Pericardial effusion%Child%Mycoplasma pneumonia IgM Elisa kit%Azithro-mycin
目的:探讨儿童肺炎支原体( MP)感染相关心包积液的临床特点,提高对该病的诊治水平。方法回顾2008年1月—2014年12月我院收治的儿童MP感染相关心包积液8例的临床资料,对临床特点、医技检查、治疗方法进行分析。结果8例均急性发病,有发热,咳嗽、气促4例,胸痛、胸闷3例,食欲缺乏1例。就诊初期6例诊断不明确,曾考虑心功能不全3例,川崎病2例,幼年特发性关节炎1例。8例心包积液均由超声心动图检查证实,其中2例因大量心包积液引起压迫症状行心包穿刺抽液处理。均经查血清MP-IgM抗体阳性明确诊断,全部予静脉-口服阿奇霉素序贯疗法治疗,6例痊愈出院,2例好转出院。出院后7例获随访,随访时间3~47个月,无一例复发。结论MP相关心包积液临床相对少见,易与其他导致心包积液的疾病相混淆而误诊,及时应用阿奇霉素疗效及预后均较好。
目的:探討兒童肺炎支原體( MP)感染相關心包積液的臨床特點,提高對該病的診治水平。方法迴顧2008年1月—2014年12月我院收治的兒童MP感染相關心包積液8例的臨床資料,對臨床特點、醫技檢查、治療方法進行分析。結果8例均急性髮病,有髮熱,咳嗽、氣促4例,胸痛、胸悶3例,食欲缺乏1例。就診初期6例診斷不明確,曾攷慮心功能不全3例,川崎病2例,幼年特髮性關節炎1例。8例心包積液均由超聲心動圖檢查證實,其中2例因大量心包積液引起壓迫癥狀行心包穿刺抽液處理。均經查血清MP-IgM抗體暘性明確診斷,全部予靜脈-口服阿奇黴素序貫療法治療,6例痊愈齣院,2例好轉齣院。齣院後7例穫隨訪,隨訪時間3~47箇月,無一例複髮。結論MP相關心包積液臨床相對少見,易與其他導緻心包積液的疾病相混淆而誤診,及時應用阿奇黴素療效及預後均較好。
목적:탐토인동폐염지원체( MP)감염상관심포적액적림상특점,제고대해병적진치수평。방법회고2008년1월—2014년12월아원수치적인동MP감염상관심포적액8례적림상자료,대림상특점、의기검사、치료방법진행분석。결과8례균급성발병,유발열,해수、기촉4례,흉통、흉민3례,식욕결핍1례。취진초기6례진단불명학,증고필심공능불전3례,천기병2례,유년특발성관절염1례。8례심포적액균유초성심동도검사증실,기중2례인대량심포적액인기압박증상행심포천자추액처리。균경사혈청MP-IgM항체양성명학진단,전부여정맥-구복아기매소서관요법치료,6례전유출원,2례호전출원。출원후7례획수방,수방시간3~47개월,무일례복발。결론MP상관심포적액림상상대소견,역여기타도치심포적액적질병상혼효이오진,급시응용아기매소료효급예후균교호。
Objective To investigate the characteristics of pericardial effusion associated with mycoplasma pneumonia ( MP) infection in children. Methods Clinical data of eight cases with pericardial effusion associated with MP during Jan. 2008 and Dec. 2012, including clinical characteristics,accessory examinations and therapies,were collected and analyzed. Re-lated literature was reviewed. Results Eight patients ran a fever, and all the patients had a history of acute onset,four pa-tients had a cough and dyspnea, and three patients had stethalgia and chest stuffiness, and one patient had a poor appetite. Six patients were not clear in the early diagnosis. There were three patients once suspected with cardiac failure, two patients of Kawasaki disease and one patient of juvenile idiopathic arthritis. Eight patients with pericardial effusion were confirmed by ul-trasonic cardiogram. Pericardiocentesis and drainage were performed on 2 patients of children with pressure symptoms caused by quantity pericardial effusion. The serum antibodies of MP IgM were positive to make a definite diagnosis for all cases. All the children were treated with intravenous oral Azithromycin sequential therapy. Six patients recovered and two were cured, and discharged from hospital. Seven patients were followed up for 3-47 months after discharge from the hospital, and there was no relapsed. Conclusion Pericardial effusion associated with mycoplasma pneumoniae( MP) infection in children is relatively uncommon, and may be easily confused with other cause of pericardial effusion diseases, which may lead to misdiagnosis, and the effect of timely Azithromycin treatment is good for prognosis.