儿童重症肺炎支原体肺炎流行病学及临床特点分析

目的 探讨儿童重症肺炎支原体肺炎（MPP）流行病学及临床特点。方法 回顾性分析东南大学附属江阴医院2014年1月至2016年12月收治住院的106例重症MPP患儿的发病季节、临床症状、实验室及影像学检查、并发症、治疗方案及预后情况。结果 重症MPP患儿中，学龄期儿童占46.23%，冬季高发，临床症状主要表现为发热、咳嗽、气急、呼吸困难，炎性指标多增高。影像学检查以大片状阴影、肺实变为主，肺不张、胸腔积液发生率分别为38.68%、27.36%；49.06%患儿出现肺外并发症；58.49%患儿加用激素，5.66%加用静脉丙种球蛋白治疗，53.77%进行电子支气管镜肺泡灌洗术，所有患儿均好转出院。结论 重症MPP的发病与年龄和季节相关，临床症状较重，影像学检查炎症明显，肺内外并发症常见，经有效抗感染、免疫支持、电子支气管镜等治疗后，预后良好。

Analysis on epidemiological and clinical characteristics of severe mycoplasma pneumonia in children

Objective To investigate epidemiological and clinical characteristics of severe mycoplasma pneumonia in children.Methods The clinical data of 106 cases of children with severe mycoplasma pneumonia in our hospital from January 2014 to December 2016 were retrospectively analyzed, including the onset of the season, clinical symptoms, laboratory and imaging studies, complications, treatment options and prognosis.Results School-aged children accounted for 46.23% of total cases with severe mycoplasma pneumonia, who had high incidence in winter. The main clinical symptoms were fever, cough, shortness of breath, difficulty in breathing and increased inflammatory index. The imaging examination was mainly composed of large lamellar shadow and pulmonary consolidation. The incidences of atelectasis and pleural effusion were 38.68% and 27.36% respectively. 49.06% of children were with extra-pulmonary complications. Hormones were added to 58.49% of children, 5.66% with plus intravenous gamma globulin treatment, and 53.77% with plus electronic bronchoscopic alveolar lavage. All children were discharged after improvement.Conclusion The incidence of severe mycoplasma pneumonia is related to age and season. Severe mycoplasma pneumonia is always with serious clinical symptoms, imaging examination of obvious inflammation, common pulmonary and extrapulmonary complications, and good prognosis can be achieved after effective anti-infection, immune support, electronic bronchoscopy and other treatments.