12例儿童难治性支原体肺炎临床分析.docVIP

精品论文 参考文献 12例儿童难治性支原体肺炎临床分析 张艳萍 （安阳市第六人民医院儿科 河南安阳 455000） 【摘要】目的 探讨难治支原体肺炎的临床表现、诊断依据和治疗方法。方法 回顾12例难治和重症支原体肺炎的临床表现、诊疗经过，查阅相关文献进行分析讨论。结果 12例患儿年龄3-12岁，年龄偏大，咳嗽程度不等；反复发热持续时间大于10天7例，小于10天4例，无发热1例；肺部CT，1例表现支气管炎，4例支气管肺炎，7例显示程度不等的肺叶实变，其中2例累及双肺，1例发生肺纤维化；5例合并少-中等量胸腔积液，1例出现大量胸腔积液；外周血白细胞计数增高9例，正常3例；CRP正常2例，增高10例；中度贫血1例；心肌酶升高7例；谷丙转氨酶增高2例，尿蛋白阳性1例。12例患儿应用大环内酯类抗菌素均超过7天，8例联合应用了头孢类抗菌素，7例应用了肾上腺皮质激素甲强龙，3例输用丙种球蛋???,1例同时输用血浆，同时合并贫血，输用了压积红细胞，其中3例转上级医院，随访最后1例发生肺纤维化。结论 难治性支原体肺炎发病年龄偏大，年龄范围较窄，容易转为重症，合并感染，合并肺外并发症，要注意早期识别，必要时可加用肾上腺皮质激素，输用丙种球蛋白等，合并细菌感染必要时可联合应用抗菌素。 【关键词】 儿童 支原体肺炎 临床分析 【中图分类号】R730.5 【文献标识码】A 【文章编号】2095-1752（2013）25-0157-01 Clinical analysis of 12 cases of severe mycoplasma pneumonia of children.Zhang Yanping. Department of Pediatrics , the Sixth People, s Hospitalof Anyang City , Henan Anyang 455000. 【Abstract】Objective To explore the diagnosis and treatment of severe mycoplasma pneumonia of children. Methods Clinical manifestations,diagnosis and treatment of 12 cases of severe mycoplasma pneumonia of children were reviewed. Results 12 chilidren were 3-12 years old, coughed in variety. 7 cases had been fevering for more than 10 days, 4 cases less than 10 days and 1 cases no fever.Lung CT, one case menifested bronchitis, 4 cases bronchial pneumonia and 7 cases consolidation of lobi pulmonis .5 cases had small ndash;medium pleural effusion and 1 case a great deal .Peripheral white blood cell counts of 9 cases rised and 3 cases were normal . 2 cases had normal CRP and 10 cases rised. 1 case was complicated by moderate anemia. 7 cases Myocardial enzyme and 2 cases glutamic-pyruvic transaminase rised .1 case urine protein was positive. 12 patients with macrolides antibiotics were more than 7days , and 8 cases cephalosporin antibiotics were combined . 7 cases methyl prednisolones were applied. 3 patients received gamma globulin, ang one of them received blood plasma and packed red cells. 3 severe patients were transf