摘要
目的探討難治性肺炎支原體肺炎(RMPP)的發病特點,以提高對肺炎支原體肺炎的診療水平。方法對本院2012年5月~2012年7月的14例RMPP的臨床表現、實驗室檢查、影像學結果、治療過程及轉歸進行分析總結。結果14例難治性肺炎支原體肺炎起病均表現爲發熱、刺激性咳嗽,發熱持續時間長,咳嗽劇烈。胸片示肺實質性滲出灶,胸腔積液4例,胸片改變持續時間長。14例均給予大環内酯類抗生素及吸入性糖皮質激素(ICS)治療。5例經靜脈使用糖皮質激素治療。1例大片肺實變患者經支纖鏡沖洗治療。隨訪1~2個月,除2例未複查胸片的患兒,全部病例胸片陽性改變消失。結論RMPP病情重,病程遷延,應及早行胸片及病原學檢查以早期診斷,聯合使用大環内酯類抗生素和ICS對RMPP有效,對於出現全身炎症反應、肺部滲出重及明顯胸膜反應者應早期靜脈使用糖皮質激素。
Objective To study the clinical characteristics of refractory mycoplasma pneumoniae(RMPP),in order to improve the ability of diagnosis and therapy for RMPP.Methods Clinical data(including the clinical characteristics,laboratory examination,pulmonary radiographic findings,therapeutic regimen and outcome)of 14 children with RMPP,who were treated in Kiang Wu Hospital from May to July in 2012,were analyzed.Results All cases were manifested as prolonged fever,irritable cough.The pulmonary radiographic findings showed the exudative changes in lung parenchyma.4 cases had pleural effusion.And all pulmonary radiographic findings are persistent.14 cases were treated with Macrolide antibiotics and inhaled corticosteroid(ICS).5 cases were treated with intravenous corticosteroid.Bronchofiberoscope lavage was used in one case because of pulmonary consolidation.Follw up for one to two months,the pulmonary radiographic findings in 12 cases disappeared completely except 2 cases who didn’t repeat the chest X-Ray.Conclusion The clinical characteristics of RMPP cases are severe and persitent.Early CXR and etiological examination are useful for early diagnosis.The combined use of Macrolide antibiotics and ICS is effective for RMPP.RMPP cases with systemic inflammatory response,severe pulmonary exudative changes and pleural effusion should be treated with intravenous corticosteroid as early as possible.
作者
卓觀達
李靜
陳彥
曾駿賢
宋冬其
潘寶全
CHEOK Kun Tat;LEI Cheng;CHEN Yan;CHANG Chon In;SONG Dong Qi;PAN Bao Quan(Department of pediatrics,Kiang Wu Hospital,Macao,China)
出处
《镜湖医学》
2013年第1期37-40,共4页
MEDICAL JOURNAL OF KIANG WU
关键词
支原體肺炎
兒童
治療
激素
Mycoplasma pneumoniae
Child
Treatment
Corticosteriod
