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目的:分析不同年龄阶段儿童大叶性肺炎的临床特点、病原学变迁及治疗转归。方法:对2010年1～12月218例不同年龄阶段的儿童大叶性肺炎患儿的临床症状、体征、病原学特点及治疗转归进行回顾性分析。结果:临床治愈198例(占90.8%),好转12例(占5.5%),转外科手术8例(占3.7%);平均住院18.2天(最长32天)。结论:对于发热、咳嗽3天以上的年长儿或者呼吸急促的婴幼儿应尽早作胸片或胸部CT,以免造成大叶性肺炎的误诊、漏诊。婴幼儿大叶性肺炎极易合并多脏器功能不全。婴幼儿大叶性肺炎感染主要以革兰氏阴性杆菌为主,极少合并支原体感染,一般不需加用阿奇霉素。大叶性肺炎疗程一般为14～21天,胸部CT完全吸收不是停药的标准。
Objective: To analyze the clinical features, etiological changes and treatment of lobar pneumonia in children of different ages. Methods: A retrospective analysis of clinical symptoms, signs, etiological characteristics and treatment outcome of 218 children with lobar pneumonia of different ages from January to December in 2010 was conducted. Results: 198 cases were cured (90.8%), 12 cases were improved (5.5%), 8 cases were surgery (3.7%), and the average hospitalization was 18.2 days (up to 32 days). Conclusion: For fever, cough for more than 3 days older children or infants and young children should be as soon as possible chest X-ray or chest CT, so as to avoid the misdiagnosis and missed diagnosis of lobar pneumonia. Baby lobe pneumonia easily combined with multiple organ dysfunction. Mycoplasma pneumonia infection mainly in Gram-negative bacilli, minimal mycoplasma infection, generally do not need to add azithromycin. Lobkle pneumonia treatment is generally 14 to 21 days, chest CT is not completely absorbed by the standard withdrawal.