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目的探讨肺炎支原体(MP)肺炎患者肺外并发症的分布特点及临床诊断、治疗方法。方法收集经血MP-IgM检测阳性,确诊为支原体肺炎的1100例患儿的临床资料,统计417例肺外并发症患者(并发症组)的分布临床特点及MP-DNA检出率,并与683例无并发症组相关资料进行比较;分析4年间各种并发症的发生情况;比较行纤维支气管镜(纤支镜)灌洗术和未手术患者的相关资料。结果并发症组血MP-DNA检出率、住院时间均高于无并发症组,肺外并发症以肝功能损害、皮疹、胃肠道反应多见,但较轻;脑炎、肾炎、心肌炎少见、但严重而隐匿;致命的噬血细胞性淋巴组织增生症(HLH)亦可见。纤支镜灌洗术有利于病情恢复。结论 MP肺炎肺外并发症发生率高且凶险,需要临床仔细的观察和检查,动态监测化验指标及综合治疗。
Objective To investigate the distribution and clinical diagnosis and treatment of extrapulmonary complications in patients with Mycoplasma pneumoniae (MP) pneumonia. Methods The clinical data of 1,100 children with positive MP-IgM and confirmed mycoplasma pneumonia were collected. The clinical characteristics and MP-DNA detection rate of 417 patients with extra-pulmonary complications (complication group) were collected and compared with 683 The cases without complications were compared. The incidence of various complications in four years was analyzed. The relative data of patients undergoing lavage and non-operation with fiberoptic bronchoscopy were compared. Results Complications of blood MP-DNA detection rate, hospital stay were higher than the group without complications, extrahepatic complications with liver damage, rash, gastrointestinal reactions more common, but less; encephalitis, nephritis, myocarditis Rare, but serious and hidden; deadly hemophagocytic lymphohistiocytosis (HLH) is also visible. Fiberoptic bronchoscopy is conducive to the recovery of the disease. Conclusion The incidence of extrapulmonary complication of MP pneumonia is high and dangerous. It requires careful observation and examination in clinic and dynamic monitoring of laboratory indexes and comprehensive treatment.