摘要
目的:总结儿童大叶性肺炎的临床特点及治疗效果。方法:对221例大叶性肺炎患儿的临床症状、体征、治疗方法和疗效等进行回顾性分析。结果:221例儿童大叶性肺炎中199例(90.0%)以发热、咳嗽为主要临床症状;肺部体征阴性154例(69.7%),肺部体征阳性67例(30.3%),阳性体征包括可闻及呼吸音弱或湿啰音;病程在1周以上者151例(68.3%);221例X线胸片均可见到节段或大叶分布的大片状密度增高阴影。结论:大叶性肺炎近年发病率明显增高,已成为由细菌、病毒、肺炎支原体(MP)混合或单一感染的疾病,临床表现越来越不典型,容易误诊,在临床中发现连续发热、咳嗽、咳痰等不典型肺炎症状的患儿应及早查血常规、拍X线胸部正位片,查肺炎支原体IgM抗体(MP-IgM)等,明确诊断,在病原不明确时,及时用β-内酰胺类联合大环内酯类抗生素,采用降级治疗,以免贻误病情。
Objective：To summarize the clinical features of lobar pneumonia in children and its treatment effect.Methods： The clinical symptoms,signs,treatment and curative effects of 221 cases of lobar pneumonia in children were analyzed retrospectively.Results： Among 221 children with lobar pneumonia,199（90.0%） patients showed fever,cough as the main clinical symptoms;15 cases（69.7%） with pulmonary negative signs,67 cases（30.3%） with pulmonary positive signs,including weak breath sounds or wet rales being heard;151 cases（68.3%） with course of 1 week or more;221 cases,from X-ray sternum,with large flake density-increased shadow in the segments or large leaves of the lung.Conclusion： The incidence of lobar pneumonia was significantly increased in recent years and it has become a disease infected by bacteria,viruses and mixed or single Mycoplasma pneumoniae（MP）.Its clinical manifestations became less typical and easily misdiagnosed.If continuous fever,cough,sputum and other symptoms of atypical pneumonia were found in children,early examination should be made,including checking blood routine,taking X-ray chest anteroposterior film,checking Mycoplasma pneumoniae IgM antibodies（MP-IgM） and other laboratory examinations.Then right diagnosis should be given.When the pathogen was not clear,timely β-lactam combined with macrolide antibiotics should be given for degradation treatment in order to avoid delay of treatment.
出处
《中医儿科杂志》
2011年第5期16-18,共3页
Journal of Pediatrics of Traditional Chinese Medicine
关键词
儿童
大叶性肺炎
临床分析
children
lobar pneumonia
clinical analysis
作者简介
万雅平（1967-），女，副主任医师，主要从事呼吸及消化疾病的诊断及治疗。
