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目的探讨小儿难治性肺炎支原体肺炎的诊断和治疗。方法回顾性分析78例小儿难治性肺炎支原体肺炎的临床特点及治疗情况。结果 78例小儿难治性肺炎支原体肺炎均以发热、咳嗽起病,热型多表现为稽留热,咳嗽呈阵发性干咳。血清特异性MP-IgM均为阳性,效价均>1∶160。X线胸片示大片高密度影58例,以右侧中、下肺野多见(17例为双侧,41例为单侧),12例为斑点或斑片状阴影,8例肺纹理增粗、紊乱,肺门周围模糊影;4例伴不同程度的胸腔积液。出现心肌损害8例,肝功能损害6例,脑损害3例;合并细菌感染12例,病毒感染4例。78例均给予大环内酯类抗生素治疗4周,46例加用地塞米松及丙种球蛋白治疗,发热及咳嗽症状改善快,合并其他病原体感染的给予敏感的抗生素及抗病毒治疗,有肺外并发症的给予相应的治疗。随访2个月,全部病例治愈,未见复发。结论虽然小儿难治性肺炎支原体肺炎病情严重且病程迁延,但经合理治疗均可痊愈。
Objective To investigate the diagnosis and treatment of pediatric intractable pneumonia mycoplasma pneumonia. Methods Retrospective analysis of 78 cases of pediatric intractable pneumonia mycoplasma pneumonia clinical features and treatment. Results 78 cases of infantile intractable pneumonia mycoplasma pneumonia were fever, cough onset, hot type of performance for the remaining heat, cough was paroxysmal dry cough. Serum-specific MP-IgM were positive, the titers were> 1: 160. X-ray showed large high-density film 58 cases, to the right and middle and lower lung field more common (17 cases of bilateral, 41 cases were unilateral), 12 cases of spots or patchy shadows, 8 cases of lung texture Thickening, disorganized, fuzzy around the hilar shadow; 4 cases with different degrees of pleural effusion. Myocardial damage occurred in 8 cases, 6 cases of liver damage, brain damage in 3 cases; bacterial infection in 12 cases, 4 cases of viral infection. 78 cases were given macrolide antibiotics for 4 weeks, 46 cases plus dexamethasone and gamma globulin treatment, fever and cough symptoms improved quickly, combined with other pathogen infection given sensitive antibiotics and antiviral therapy, there is extrapulmonary Complications are given to the appropriate treatment. Follow-up 2 months, all cases were cured, no recurrence. Conclusions Although pediatric refractory Mycoplasma pneumoniae pneumonia is exacerbated and its duration is prolonged, it can be cured by reasonable treatment.